- Excellus BlueCross BlueShield (Rochester, NY)
- …. Ensures accurate payment by independently utilizing DRG grouper, encoder, and claims processing platform. . Manages case volumes and review/audit schedules, ... 10CM, MS-DRG, and APR-DRG with a broad knowledge of medical claims billing/payment systems, provider billing guidelines,.... Intermediate knowledge of PC, software, auditing tools and claims processing systems. Level II (in addition… more
- FLACRA (Newark, NY)
- …outstanding balances. + Work with insurance companies to address disputed claims and resolve processing issues. + Maintain and update tracking spreadsheets ... Accounting: Accounts Receivable, Medical Biller FLACRA Newark, NY (Onsite) Full-Time $20.00...and payment collection processes. This position is responsible for processing claims , managing accounts receivable, and ensuring… more
- Robert Half Accountemps (Rochester, NY)
- …and a commitment to providing high-quality service. Responsibilities: * Process and submit medical claims to insurance providers, ensuring accuracy and ... key role in managing billing operations, ensuring accuracy in claims processing , and maintaining compliance with healthcare...MEDENT and Epic EMR systems. * Strong understanding of medical claims processes and insurance … more
- Mount Sinai Health System (New York, NY)
- …processes, and related regulations. ? Familiarity with contract terms, NYS regulations, claims processing , and healthcare reimbursement models. ? Experience in ... potential legal intervention, and assisting in the escalation of claims that may require involvement from insurance ...to ensure proper interpretation and application of terms during claims processing . * Ensure that all contract… more
- Humana (Albany, NY)
- …coding certification from the AAPC and/or AHIMA) + Extensive knowledge of medical claims processing and familiarity with reimbursement methodologies, ... in healthcare or business-related field + Knowledge of internal Medical Coverage Policies and Claims Payment Policies...Policies and Claims Payment Policies + CAS claims processing experience + Experience in data… more
- Access: Supports For Living (Middletown, NY)
- …identified revenue cycle billing issues + Handling billing cycle review procedures for pre- processing (scrubbing) of weekly claims processing + Analyze, ... billing and processing program claims for accuracy and completeness; submit claims ...well as on a collaborative team. + Knowledge of Medical Insurance programs such as Medicaid, Medicare… more
- Humana (Albany, NY)
- …Operations encompasses critical functions including care coordination, quality measurement, billing, claims processing , and customer service, each essential to ... claims , and customer service). + Collaborate with each Insurance Operations function to identify, understand, and align Stars-related business strategies,… more
- Molina Healthcare (Buffalo, NY)
- …of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing , etc.) + Knowledge of healthcare financial terms ... of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management, Network, and other departments to enable critical… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- **Job Summary** The Senior Director, Medical Communications, Nephrology & Immunology directs and provides strategic leadership for the global scientific ... directing the development and dissemination of all core scientific and medical content (eg, global slide decks, congress abstracts/presentations, publications, … more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- The Manager, Medical Core Content is a team-level operational role responsible for the development, maintenance, and day-to-day quality assurance of all core ... scientific and medical content for the relevant therapeutic area. This role...life, accidental death & dismemberment, short-term and long-term disability insurance , tuition reimbursement, student loan assistance, a generous 401(k)… more