- City of New York (New York, NY)
- …for one (1) Principal Administrative Associate III to function as an Operation Supervisor who will: - Directly and indirectly supervise ARU staff which consists of ... and Principal Administrative Associates involved in claim review and processing . - Assign, evaluate and review completed cases by...Social Security Administration on any issues related to the claims or the use of the Government Service Online… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Assesses staff and unit training needs and reports this information to the supervisor . + Collaborates with other key departments ( Claims , Customer Service, ... policies and procedures and related health plan functions such as member services, claims , and the referral process. As well as functions related to legislative and… more
- Mount Sinai Health System (New York, NY)
- …required. Familiarity with CPT and ICD (coding and CCI edits) + Electronic claims processing preferred. **Responsibilities** 1. Follows up on submitted claims ... May transfer secondary balances to appropriate financial class and provides documentation for processing the claims . 6. Reviews Credit Letter Sent (CLS) and… more
- University of Rochester (Rochester, NY)
- …through telephone calls, payer website, and written communication to ensure accurate processing of claims . 15% + Follows established procedure for missing ... individual, and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE The claims resolution representative II is responsible for working across the… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Medicaid, CPT, HCPCS, ICD10, DRG, APC, RBRVS, etc.). + Extensive experience with claims processing systems, claims flow, adjudication process, system edits ... in a clear and concise manner. + Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns. + Manages cases as assigned,… more
- Walmart (Albany, NY)
- …by ensuring proper policies and procedures are followed Ensures the timely processing of claims forexample damaged defective returned liquidated items and ... facilitylevel training and execution of asset protection safety and claims and receiving procedures by reviewing the application of...of college. Option 2: 1 year's experience as a supervisor in a multi-department environment. Option 3: 1 year's… more
- OLV Human Services (Lackawanna, NY)
- …standards. A critical part of the role involves evaluating insurance coverage, managing claims processing , and ensuring all aspects of patient care are ... with Finance to ensure patient charts are updated appropriately, if claims are denied/rejected. * Implement and maintain systems for insurance verification,… more
- Rochester Regional Health (Rochester, NY)
- …effectively and accurately managing a receivable. Resolve edits to ensure accurate claims are sent to primary and secondary insurances. Research and resolve denials ... policies and/or phone calls to the payer. Submit corrected claims and appeals. + Process account adjustments and refunds...and system updates. Report problems and patterns to the supervisor to help keep policies and procedures up to… more
- Cardinal Health (Albany, NY)
- …Collections is responsible for the timely follow-up and resolution of insurance claims . This role ensures accurate and efficient collection of outstanding balances ... billing system according to departmental procedures. + Follow up on unpaid claims within payer-specific guidelines and timelines. + Coordinate with other billing… more
- Lakeview Health Services (Geneva, NY)
- …supervision, is responsible for a variety of office/clerical tasks relating to claims processing ; contacting responsible parties to resolve past-due accounts; ... by batch in accordance with established protocol + Submit claims to 3rd party sources of payments + Post...funding continuity and stability + Perform prompt and accurate processing of all bank deposits and transfers + Post… more