- University of Rochester (Rochester, NY)
- …independent decisions as to the processes necessary to collect denied insurance claims and resolve billing issues. Must track payer/billing issues that affect ... reimbursement of claims and advising the management team of those trends...obtained from a nationally accredited billing program (ie, Certified Medical Billing Specialist CMBS, Certified Medical Records… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …medicines for those with CNS disorders, we are seeking a skilled and experienced Medical Director of CNS Early Assets, Global Medical Affairs, responsible for ... certain assets within the broader CNS TA portfolio Medical Affairs (both US and Global), with a specialization...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Sedgwick (Albany, NY)
- …time frames, and claims status either by phone, written correspondence and/or claims system. + Reviews medical information to determine if the claimant meets ... live within the United States. **PRIMARY PURPOSE** **:** To process claims and determine accommodation options following written guidelines and procedures pursuant… more
- Independent Health (Buffalo, NY)
- …dedicated to pharmacy system administration and reporting, vendor delegation oversight, medical pharmacy claims processing and training. They will establish ... + Serve as pharmacy department subject matter expert on medical drug claims . + Coordinate with pharmacy..._As an Equal Opportunity / Affirmative Action Employer, Independent Health and its affiliates will not discriminate in its… more
- Elevance Health (Latham, NY)
- …healthcare fraud in order to recover corporate and client funds paid on fraudulent claims . Health insurance experience required with understanding of health ... be considered. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to… more
- Sedgwick (Albany, NY)
- …operations of multiple teams of examiners and technical staff for disability claims for clients; to monitor colleagues' workload, provide training, and monitor ... individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims within… more
- Travelers Insurance Company (Melville, NY)
- …and resolving assigned General Liability related Bodily Injury and Property Damage claims . Provide quality claim handling throughout the claim life cycle (customer ... such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of… more
- Travelers Insurance Company (Melville, NY)
- …and resolving assigned General Liability related Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim life cycle (customer ... not manage staff. **What Will You Do?** + Directly handles assigned severe claims . + Provides quality customer service and ensures file quality and timely coverage… more
- Kelly Services (New York, NY)
- **Sales Assistant - Health Benefits** **Location: Brooklyn or NYC - Hybrid** **Salary: $26-32/hour** **Direct Hire Opportunity!** Are you looking to launch a long ... career in the thriving ** Health Benefits Administration** field? **Kelly** has an amazing opportunity...data is systematically organized and stored correctly. + Request claims reports from carriers and assess the claims… more
- Albany Medical Center (Albany, NY)
- …of the 340B program. This person will extensively audit prescription claims and report findings while making recommendations for program compliance improvement. ... + Assess the logic used to qualify 340B prescription claims + Perform audits of 340B claims ...to HRSA requirements + Learn to navigate hospital electronic medical record systems (Allscripts, Cerner, etc) + Complete reports… more
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