- MVP Health Care (Schenectady, NY)
- …requires innovative thinking and continuous improvement. To achieve this, we're looking for a Claims Examiner to join #TeamMVP. If you have a passion for medical ... claims and attention to detail this is the opportunity...York** **Qualifications you'll** **bring:** + High School Diploma required. Associate degree in health, Business or related field preferred… more
- Highmark Health (Albany, NY)
- …the department. + Serve as the liaison between the department and the claims processing departments to facilitate care/case management activities and special ... is a non-clinical resource that coordinates, analyzes, and interprets the benefits and claims processes for clinical teams and serves as a liaison between various… more
- KPH Healthcare Services, Inc. (East Syracuse, NY)
- …Care, and private billing, claim corrections and follow-up + Track and re-bill pending Medicaid accounts + Re-bill claims as needed + Identify pattern problems ... **Overview** **Scope of Responsibilities** : The Administration Billing Associate is responsible for identifying, researching, rectifying, and maintaining accurate… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …, 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
- Healthfirst (NY)
- …to senior staff. + Complete subsequent auditing and handling of specific claims and appeal requests including processing where applicable, tracking, documenting, ... + Conduct moderately complex to complex quality audits of provider claims , pre-payments and post-payments including high-dollar and specialized claims … 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
- Humana (Albany, NY)
- …CFE, AHFI) * Experience testifying in court * Understanding of healthcare industry, claims processing , and investigative process development * Experience in a ... Market Areas o Clinical Teams o Business areas for all product lines (Medicare, Medicaid , Commercial) o Industry Trend areas **Use your skills to make an impact**… more
- Westchester Jewish Community Services (White Plains, NY)
- …Medicaid and 3rd Party Insurance. This position ensures timely and accurate processing of claims , collections, and account reconciliations to support the ... to: + Process and review billing for Managed Care, Medicaid , and Third-Party Payers, ensuring timely claim submission, editing,...are seeking candidates who possess the following qualifications: + Associate degree OR a High School diploma with at… more
- City of New York (New York, NY)
- Job Description YOU MUST BE PERMANENT IN THE CLERICAL ASSOCIATE TITLE OR IF YOU ARE HIRED PROVISIONALLY AS A CLERICAL ASSOCIATE III, YOU MUST TAKE AND PASS THE ... CLERICAL ASSOCIATE CIVIL SERVICE EXAM WHEN IT BECOMES AVAILABLE. BFI...(OAS) is the central repository for the receipt and processing of negotiable instruments in compliance with the NYC… more
- Humana (Albany, NY)
- …Certifications, CPC, CCS, CFE, AHFI) + Understanding of healthcare industry, claims processing and internal investigative process development + Experience ... opportunity for this job. Our Fortune 100 Company values associate engagement & your well-being. We also provide excellent...Bachelor's Degree + Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years of… more