- Rochester Regional Health (Rochester, NY)
- …sent to primary and secondary insurances . Research and resolve denials and payer requests for information promptly and accurately in order to secure payment. Work ... 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
- Ellis Medicine (Schenectady, NY)
- …meetings with all payers to continuously improve communications between provider and payer in order to resolve issues, reduce outstanding aged accounts, increase ... then claims will be submitted daily to the appropriate payer as indicated. + Analyze 277 Rejection Remittance Reports...allowances. + Unidentified cash will be researched with the payer for correct posting, or be refunded to the… more
- KPH Healthcare Services, Inc. (East Syracuse, NY)
- …third-party payers. **Responsibilities** **Job Duties:** + Review and interpret third-party payer contracts, fee schedules, and reimbursement terms. + Analyze ... payer benefit structures, reimbursement trends, and payment integrity issues....and nurture strong working relationships with PBM representatives and payer partners to ensure favorable contract outcomes and resolve… more
- Intermountain Health (Albany, NY)
- …procedures and policies with an overall goal of account resolution. + Initiates payer recoupments, payer refunds, and patients refunds where applicable. Follows ... policies with an overall goal of account resolution. + Abel to navigate various payer claim portals and understand payer functionality. + Interacting with others… more
- The Wesley Community (Saratoga Springs, NY)
- …Duties: + Responsible for timely and accurate insurance claim submissions for all payer types. + Monitor and maintain aging reports for outstanding claims. Respond ... setting. + Extensive knowledge of billing procedures for all payer types including Medicare, NY Medicaid, HMO and Private...with insurance clearinghouses such as Waystar preferred and with payer portals including EPACES, Connex and Omnipro. + Must… more
- Rochester Regional Health (Rochester, NY)
- …computer system reviewing for mandatory precertification and/or other third party payer requirements* Collects complete financial information to include payer ... eligibility via insurance websites, where appropriate* Completes Medicare Secondary Payer Questionnaire for all Medicare-eligible patients* Completes all admission… more
- University of Rochester (Rochester, NY)
- …up activities on denied, unpaid, or underpaid accounts, as well as contacts payer representatives to research and resubmit rejected claims to obtain and verify ... working claims. + Reviews reasons for claim denial. + Reviews payer website or contacts payer representatives to determine why claims are not paid. + Determines… more
- University of Rochester (Albany, NY)
- …up activities on denied, unpaid, or underpaid accounts, as well as contacts payer representatives to research and resubmit rejected claims to obtain and verify ... accounts working claims. Reviews reasons for claim denial. Reviews payer website or contacts payer representatives to...claim denial. Reviews payer website or contacts payer representatives to determine why claims are not paid.… more
- University of Rochester (Rochester, NY)
- …of the outstanding claim. The Specialty A/R associate will utilize MFG and/or payer billing software and will adhere to documented policies, procedures and workflows ... Utilizes A/R experience and knowledge of billing software system, third party payer requirement and insurance regulation to resolve complex accounts in specialty… more
- Regeneron Pharmaceuticals (Sleepy Hollow, NY)
- …at the individual level, while incorporating a portfolio approach. A deep understanding of payer systems in the US and major ex-US markets is a key requirement. The ... global market access requirements to the organization and integrating timely payer perspectives into marketing and clinical development activities and decisions.… more