- University of Rochester (Rochester, NY)
- …will make independent decisions as to the processes necessary to collect denied insurance claims , no response accounts, and will investigate resolving billing ... payers to obtain payments, as well as contact payer representatives to research/resubmit rejected claims to obtain and verify insurance coverage. + Follow up on… more
- Sedgwick (Albany, NY)
- … claims thoroughly using technical expertise and complex analysis. + Examines insurance policies, claims , and other records to determine insurance ... Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Adjuster National Marine **PRIMARY PURPOSE** **:** Analyzes, investigates, evaluates,… more
- Centene Corporation (New York, NY)
- …including compliance requirements are adhered to for the appropriate handling of medical necessity, claims denials, and bundling issues. + Provide regular ... to respond to ICD-10 coding changes and its effect on inpatient claims payment. Chart review will include DRG pre-payment review, hospital readmission review… more
- CenterWell (Albany, NY)
- …help us put health first** The Medical Director, Primary Care relies on medical background and reviews health claims . The Medical Director, Primary Care ... an in-depth evaluation of variable factors. The Medical Director relies on medical background and reviews health claims . The Medical Director work… more
- University of Rochester (Albany, NY)
- …(EOBs), insurance correspondence, rejections received thru daily electronic and claims submission, etc. + Research claims , identify problems, and take ... individual, and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE The Claims Resolution Representative III is responsible for working across the… more
- World Insurance Associates, LLC. (Syosset, NY)
- Summary Paul Global Benefits (PGB) is now a part of World Insurance Associates. World Insurance Associates is a unique insurance organization offering top ... agents. Founded in 2011, World is one of fastest-growing insurance brokers in the US with over 2,200 employees...setup of online benefits enrollment support tools. + Resolves claims or administrative issues on behalf of client, escalates… more
- Philadelphia Insurance Companies (Melville, NY)
- …Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an ... Description Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine...with functional leaders in Actuarial, IT, Stat, Underwriting and Claims throughout the product development cycle. Responsible for the… more
- ConvaTec (Massapequa, NY)
- …completeness of all required information prior to submission. + Follows up with insurance companies on unpaid or rejected claims . Resolves issues and resubmits ... **About Convatec** **Pioneering trusted medical solutions to improve the lives we touch:**... claims . + Reads and interprets insurance explanation of benefits. Maintains specialized knowledge in … more
- UNUM (Albany, NY)
- …Physical Medicine and Rehabilitation. This position is responsible for providing expert medical analysis of claims files (or underwriting applications) across ... Unum US product lines. The incumbent provides high quality, timely, and efficient medical consultative services to the Benefits Center. The Medical Consultant… more
- MTA (Brooklyn, NY)
- …reduce overall costs. Some of the major responsibilities include supervising the TPA's claims management and medical provider networks as well as coordinating ... (Case Management), is responsible for effective management of worker compensation claims for their assigned area of responsibility. This person supports the… more