- Humana (Albany, NY)
- **Become a part of our caring community and help us put health first** The Supervisor , Claims Review makes appropriate claim decision based on strong ... procedures, contract provisions, and state and federal legislation. The Supervisor , Claims Review works within thorough, prescribed guidelines and… more
- Sedgwick (Albany, NY)
- …equivalent combination of education and experience required to include two (2) years claims supervisor experience. **Skills & Knowledge** + Thorough knowledge of ... management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and… more
- Sedgwick (Albany, NY)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Advisor, Environmental | Professional Liability | REMOTE **Job Description Summary** ... To analyze complex or technically difficult environmental claims ; to provide resolution of highly complex nature and/or severe injury claims ; to coordinate case… more
- Carrington (Albany, NY)
- **Come join our amazing team and work remote from home!** The Sr Claims &Recovery Analysis Loss Specialist is responsible for ensuring the proper incurred losses ... this position is $23.00/hr - $26.50/hr. **What you'll do:** Review reconciliation of all loan advances once the GSE...manual processes and activities. + Keep Team Lead and Supervisor informed of all trends and problems including, but… more
- Ryder System (Albany, NY)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **SUMMARY** This ... position supervises adjusters and directly handles claims within Ryder's self-insured, self-administered liability program. Oversees claim-handling processes… more
- Albany Medical Center (Albany, NY)
- …of America) Salary Range: $65,102.17 - $100,908.37 Salary Range: $28.99 - $46.39 The Supervisor is responsible for the day to day staff oversight and daily billing ... unit is comprised of 25 ASA level staff. The Supervisor shall use independent judgment and discretion as it...daily basis Validate timely follow up on all outstanding claims Validate timely submission of all payor appeals for… more
- Trinity Health (Albany, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **Authorization and Denial Supervisor - Hybrid - Must be local to Albany,NY** **Summary** This ... quality of work. + Leads oversight of appeals denied claims for elated services, drugs, treatments and supplies. +...of HIPAA laws and requirements as they relate to review and reporting of documentation. **Pay Range:$25.85 - $37.50**… more
- Ellis Medicine (Schenectady, NY)
- …system on a daily basis, and ensuring outgoing data is accurate. Review and resolve outstanding accounts receivable with insurance companies and patients. EDUCATION ... system on a daily basis, and ensuring outgoing data is accurate. + Review and resolve outstanding accounts receivable with insurance companies and patients. + … 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 ... receivable and increase cash flow for the organization. **_Responsibilities:_** + Review aging reports and work insurance accounts to ensure timely resolution… more
- Walgreens (Hudson, NY)
- …the unique communities we serve as requested by Store Manager, Healthcare Supervisor , or District Manager. Operations + Counsels patients and answers questions ... and federal controlled substance laws when filling prescriptions. The Product Review /Retail Fill Process Pharmacist is responsible for ensuring that elements of… more
- Cardinal Health (Albany, NY)
- …to patient inquiries in a professional and timely manner. **_Responsibilities:_** + Review aging reports and work patient accounts to ensure timely resolution and ... billing questions and set up payment arrangements if needed. + Analyze claims , process payments and complete adjustments + Analyze explanation of benefits (EOBs)… more
- Cardinal Health (Albany, NY)
- …payment + Work average of 50 to 100 denials per day based on supervisor requirements and accounts assigned + Works closely with insurance carriers for reimbursement ... + Consults with appeals department for disputed / denied claims . + Works / Understands electronic claim interchange +...other status protected by federal, state or local law._ _To read and review this privacy notice click_ here… more
- Walgreens (West Sand Lake, NY)
- …the pharmacist, including those to physicians. Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and ... Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages… more
- Walgreens (East Greenbush, NY)
- …as immunizations. Responsible for ensuring the proper compounding, dispensation, review and verification of prescribed medications within regulatory guidelines, ... and federal controlled substance laws when filling prescriptions. The Product Review /Retail Fill Process Pharmacist has the ultimate responsibility for ensuring that… more
- New York State Civil Service (Albany, NY)
- …programmed changes;* Use the web-based SAMS software program to perform the annual review of school district State Aid claim submissions to ensure reasonability of ... post-edit claim verification projects;* Process revisions to school districts' prior year aid claims to ensure correct aid is paid and overpayments of aid previously… more
- Veterans Affairs, Veterans Health Administration (Albany, NY)
- …use of evidence based medicine and peer review . Participates in clinical review process such as tort claims , peer reviews, management reviews and ... are determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. Learn… more
- CVS Health (Albany, NY)
- …distribution of the monthly premium invoices. The Billing Premium Consultant must review invoices for reasonability and accuracy and make any necessary adjustments ... billing systems. + Execute monthly invoices on appropriate billing platform and review group specifications to ensure all appropriate information is included with… more
- Trinity Health (Albany, NY)
- …ethical coding. Recognizes and reports opportunities for documentation improvement to the Supervisor of Risk Adjustment Coding & Audit to develop and implement ... a Certified Risk Adjustment Coding Specialist will do: . Review and assigns accurate ICD-10-CM codes for diagnoses assigned...diagnoses assigned in the EHR by the providers to claims being submitted for their services. Using billing system… more
- Walgreens (Troy, NY)
- …Quality Improvement Program. + Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment rejections. Follows-up with ... one's own performance, solicits for constructive feedback, and leverages Healthcare Supervisor as mentor and coach. **Communication** + Communicates with pharmacy… more