- University of Rochester (Rochester, NY)
- …arrangements, and specialized services. Revenue Collection activities focus on an assigned payer billed at the primary level. Activities performed will focus on ... to collect denied insurance claims and resolve billing issues. Must track payer /billing issues that affect reimbursement of claims and advising the management team… more
- University of Rochester (Rochester, NY)
- …arrangements, and specialized services. Revenue Collection activities focus on an assigned payer billed at the primary level. Schedule 7:30 AM-4 PM Responsibilities ... arrangements, and specialized services. Revenue Collection activities focus on an assigned payer billed at the primary level. Activities performed will focus on… more
- University of Rochester (Rochester, NY)
- …B) clearinghouse software, third party claims systems (ePaces, Omnipro) and various payer web sites. **Typical Duties:** 30% Complex, High Dollar & Specialized ... Services Account Resolution + Through detailed knowledge of all third-party payer billing requirements and governmental contracts, independently determines the most… more
- University of Rochester (Rochester, NY)
- …Email, third party claims systems (ePaces, Connex), Epic Billing System, and various payer web sites. **Typical Duties** **:** 40% Completes follow up activities on ... accounts by use of EPIC Insurance Coverage or the Payer Website link, online systems with insurance companies, and...third-party payers to obtain payments, as well as contact payer representatives to research/resubmit rejected claims to obtain and… more
- NASCO (Albany, NY)
- …data strategy and AI architecture to enhance our industry leading SaaS healthcare payer products and corporate data management products. This hands-on leader will be ... analytics strategy, platforms and patterns, AI/ML governance, and US healthcare payer regulatory compliance (eg, HIPAA, HITRUST, CMS). This person leads Data… more
- Mount Sinai Health System (New York, NY)
- …- Case Management - MSH, Mount Sinai Hospital **Responsibilities** + **Admission: Payer Authorization & Denials Management.** Communicate with payer to obtain ... is established),_ follows up at regular interval to ensure payer response. Coordinate peer to peers _(ie If case...entered into electronic tracking system including the following: Process payer denial correspondence mail, end of day reports and… more
- University of Rochester (Rochester, NY)
- …of revenue has been collected, using detailed understanding and application of all payer contracts. + Contacts applicable agency, payer or department for ... for questions from assigned collection and billing staff on payer policies, procedures and methods of revenue collection. +...new staff on the use of the billing application, payer systems, and clearinghouse systems. + Demonstrates how to… more
- Stony Brook University (Commack, NY)
- …changes affecting the organization. + Monitor and dispute Managed Care payer reimbursement policies or practices that breach contract terms, track resolution ... and physician contracting within a hospital, health system, physician group, or payer environment. + Must have direct, hands-on experience negotiating and managing… more
- University of Rochester (Rochester, NY)
- …delays from admission/arrival until the final bill is produced and any payer denials associated with the above. **ESSENTIAL FUNCTIONS** **_Customer Interactions_** + ... history by utilizing the hospital system along with all third-party payer systems. + Obtain benefits; pre-certification requirements and/or completes notification of… more
- Rochester Regional Health (Rochester, NY)
- …are sent to primary and secondary insurances. Research and resolve denials and payer requests for information promptly and accurately in order to secure payment. ... established processes. Research and resolve denial issues via the payer website, coverage policies and/or phone calls to the... website, coverage policies and/or phone calls to the payer . Submit corrected claims and appeals. + Process account… more