- Humana (Albany, NY)
- …community and help us put health first** Job Description Summary The Pharmacy Claims Representative assists local pharmacies with claims adjudication to ... up and maintaining hospice/facility/pharmacy relationships under the direction of the Pharmacy Claims Team Leaders & the Pharmacy Claims (Support Services)… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …of Experience Required: 2+ years of claim processing experience with a Medicaid/ Medicare Health Plan. Preferred: Experience in health insurance product ... Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management to ensure … more
- Surgery Care Affiliates (New York, NY)
- …for Primary insurance . + Utilize the centers selected vendor for claims and eligibility and/or individual payer websites to obtain eligibility, benefits and/or ... guidelines and the process of collecting over the counter payments/deductibles/copay/co- insurance . Knowledge of payer contracts including Medicare , Medicaid… more
- Ellis Medicine (Schenectady, NY)
- …outgoing data is accurate. + Review and resolve outstanding accounts receivable with insurance companies and patients. + Claims in dispute with payers are ... The Accounts Receivable Representative will be responsible for achieving accurate and...+ Review Billing Exception Report for Revenue Management, the Medicare system (FISS), and the claims scrubber… more
- Cardinal Health (Albany, NY)
- …the right things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of ... from AR & Billing leadership teams.** **_Responsibilities_** + Processes claims : investigates insurance claims ; and...or third party policy. + Updates patient files for insurance information, Medicare status, and other changes… more
- Ellis Medicine (Schenectady, NY)
- …outgoing data is accurate. + Review and resolve outstanding accounts receivable with insurance companies and patients. + Claims in dispute with payers are ... Basic Function: The Lead Accounts Receivable Representative will be responsible for the management of...is accurate. Review and resolve outstanding accounts receivable with insurance companies and patients. Responsible for scheduling all payer… more
- Cardinal Health (Albany, NY)
- …+ Acts as a subject matter expert in claims processing. + Processes claims : investigates insurance claims ; properly resolves by follow-up & disposition. ... account receivables performance and client satisfaction. + Resolves complex insurance claims , including appeals and denials, to...or third party policy. + Updates patient files for insurance information, Medicare status, and other changes… more
- Evolent (Albany, NY)
- …+ Answer and manage inbound inquiries regarding health plan benefits and claims , eligibility, medical and other healthcare procedures, billing and payments and other ... and verbalize processes and procedures of the organization and of health insurance coverage. + Training includes a virtual classroom environment with trainers who… more
- University of Rochester (Rochester, NY)
- …accounts, check claim status on appropriate payer system or contact an insurance representative to obtain information as to why claims are not paid and steps ... decisions as to the processes necessary to collect denied insurance claims and resolve billing issues. Maintain...Excel, Access, Email, Emdeon (Fidelis Medicaid Managed Care and Medicare Part B) clearinghouse software, third party claims… more
- University of Rochester (Rochester, NY)
- …accounts, check claim status on appropriate payer systems or contact an insurance representative to obtain information as to why claims are not paid and ... decisions as to the processes necessary to collect denied insurance claims and resolve billing issues. Must...the system. - Examples of reports:- - - 2nd insurance level report - - Medicare and… more