- Sedgwick (Albany, NY)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Representative - Workers Comp (CA experience preferred) **PRIMARY PURPOSE** ... or equivalent combination of education and experience or successful completion of Claims Representative training required. **Skills & Knowledge** + Developing… more
- Sedgwick (Albany, NY)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Workers Compensation Claims Representative | New York Jurisdiction | Dedicated Client We are ... seeking a highly motivated and experienced Workers' Compensation Claims Examiners to join our team. The ideal candidate...ideal candidate will have at least 2 years of claims handling experience, with a strong background in New… more
- Elevance Health (Latham, NY)
- **Title: Claims Representative I (Health & Dental) - FEP** **Latham, NY** **Location:** This role enables associates to work virtually full-time, with the ... **Hours:** **8 AM - 4:30 PM EST, Monday - Friday.** The ** Claims Representative I** will be responsible for successfully completing the required basic training.… more
- Zurich NA (Albany, NY)
- Claims Call Centre Representative 125071 Zurich is a leading multi-line insurer that serves its customers in global and local markets. Zurich's customers include ... different levels of complexity, ensuring a positive customer experience. + Resolve complex claims inquiries and problems, judging when to pass complex queries on to… more
- University of Rochester (Albany, NY)
- …the individual, and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE The Claims Resolution Representative III is responsible for working ... appeal process taking timely and routine action to resolve unpaid claims . The Claims Resolution Representative III reports to Accounts Receivable Management.… more
- Lithia & Driveway (Latham, NY)
- …track each claim until its final resolution. + Contact the appropriate warranty claims representative regarding any claims requiring additional authorization ... each repair order against the vehicles' service history to avoid processing duplicate claims or submitting claims forshop comebacks. + Review and process all… more
- Molina Healthcare (Albany, NY)
- …of business as it relates to audits. * Delegation Oversight; voting representative for delegation oversight committees. * Liaison to Special Investigative Unit ... regarding program integrity and oversight cost expenditure. * Monitor internal compliance of Corporate Operations units via establishment of an internal compliance program, including annual, periodic, focal, etc. audits. * Request, review and perform oversight… more
- CDPHP (Albany, NY)
- …invites you to be a part of that experience. The Document Service Representative shall assume full responsibility for the completion of the necessary activities ... performing a detailed mail sort, batch preparation, and scanning of all incoming claims and correspondence to facilitate and ensure compliance with all New York… more
- St. Mary's Healthcare (Amsterdam, NY)
- …procedures to guide and educate insurance teams. . Collaborate with the Senior Claims Analyst to review issues, adjust workflows, and reduce unnecessary workloads. . ... Confirm insurance coverage, determine the need for pre-authorization on denied claims . . Monitor high-dollar denials and rebilling of denied claims . . Assess… more
- Ellis Medicine (Schenectady, NY)
- The Accounts Receivable Representative will be responsible for achieving accurate and timely accounting of all Inpatient and Outpatient accounts receivable as set by ... outstanding accounts receivable with insurance companies and patients. + Claims in dispute with payers are reviewed daily to...the provider and payers are in agreement for appropriate claims reimbursed. + Monthly meetings with all payers to… more
- Cardinal Health (Albany, NY)
- …done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of responsibilities as ... and support from AR & Billing leadership teams.** **_Responsibilities_** + Processes claims : investigates insurance claims ; and properly resolves by follow-up &… more
- Robert Half Finance & Accounting (Albany, NY)
- Description We are looking for a dedicated Workers' Compensation Customer Service Representative to join our team in Albany, New York. In this role, you will play a ... Responsibilities: * Oversee existing insurance policies to ensure audits, reports, and claims are managed in compliance with New York State regulations. * Assist… more
- Intermountain Health (Albany, NY)
- …+ **Essential Functions** + Responsible for the accurate and timely submission of claims follow up, reconsideration and appeals, response to denials, and re-bills of ... insurance claims , and all aspects of insurance follow-up and collections....issues, credit balances, sequencing of charges, and non-payment of claims . + Reconcile accounts, research and resolve various issues… more
- Elevance Health (Latham, NY)
- **Utilization Management Representative I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... essential face-to-face onboarding and skill development. The **Utilization Management Representative I** will be responsible for coordinating cases for… more
- Latham, The Pool Company (Latham, NY)
- …difference? A little about the position: Job Summary The Warranty Claim Representative is responsible for the triage and administration for all claim/repair ... service to resolve customer inquiries. + Ensure data integrity of all claims information by validating submitted information against ERP systems to supplement… more
- Molina Healthcare (Albany, NY)
- …or exceed the Plan's monthly site visit goals. A key responsibility of the Representative during these visits is to proactively engage with the provider and staff to ... arise, making an assessment when escalation to a Senior Representative , Supervisor, or another Molina department is needed. Takes...3 - 5 years customer service, provider service, or claims experience in a managed care setting. * 3+… more
- Highmark Health (Albany, NY)
- …of experience + Experience in Provider Data Management, Customer Services or Claims . + Microsoft office experience (ie Word, Excel, PowerPoint, etc.) **Preferred** + ... File systems. + Experience with the Customer Service inquiry system or claims processing concepts. **Knowledge, Skills and Abilities** + Good written and verbal… more
- CVS Health (Albany, NY)
- …routine nature. + Handle incoming calls from members and providers regarding claims status, benefits and eligibility, PPO participation, etc + Maintain department ... established performance metrics at a meets or exceeds expectations level + Work together as a team and apply the Aetna Core Values in day-to-day operations + Creating a Differentiated Service Experience + Demonstrating Service Discipline + Handling Service… more
- Molina Healthcare (Albany, NY)
- …setting. **Required Experience** + 3 - 5 years customer service, provider service, or claims experience in a managed care setting. + 3-5 years' experience in managed ... healthcare administration and/or Provider Services. + 5 years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, ie, physician, group and hospital contracting, etc. + Working… more
- Highmark Health (Albany, NY)
- …ensure they utilize various means of automated communication, as well as, claims and electronic data interchange and electronic funds transfer. Collaborate with ... sales and customer service to respond to client/broker/member inquiries regarding provider contract, claim/member issues or provider file/record/directory discrepancies. Consult with dental director/dental advisers regarding clinical-related questions and… more