- University of Rochester (Albany, NY)
- …qualifications, expertise of the individual, and internal equity considerations._ **Responsibilities:** The Claims Resolution Representative III is ... routine action to resolve unpaid claims . The Claims Resolution Representative III...claim processing and coding. Escalates system issues preventing claims submission and follow-up for review and resolution… more
- University of Rochester (Rochester, NY)
- … to obtain and verify insurance coverage. + Follows up on unpaid accounts working claims . + Reviews reasons for claim denial. + Reviews payer website or contacts ... payment and completes and documents follow up by resubmitting claim or deferring tasks. + Researches and calculates under...deferring tasks. + Researches and calculates under or overpaid claims ; determines final resolution . + Contacts payers… more
- University of Rochester (Rochester, NY)
- …insurance accounts which have not been collected through routine billing and collection activities. Claim Resolution Rep III will make independent ... to the attention of billing Manager and Supervisor. The Claim Resolution Rep III...Insurance Coverage tab), review payer website, or contact payer representative as to why claims are not… more
- University of Rochester (Rochester, NY)
- … to obtain and verify insurance coverage. Follows up on unpaid accounts working claims . Reviews reasons for claim denial. Reviews payer website or contacts payer ... claim or deferring tasks. Researches and calculates under or overpaid claims ; determines final resolution . Contacts payers on incorrectly paid claims… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Interacts with Operations, Enrollment and Billing, Customer Care, Claims , Advocacy, Clinical Operations, Medical Affairs and Finance/Underwriting Departments ... business needs while taking ownership and accountability for issue identification and resolution . Level II (in addition to Level I Accountabilities) * Assists with… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …departments including sales, medical, operations and network management. As a key representative of the corporation, this position is expected to maintain strong ... order to facilitate workflows and coordinate appropriate resources for problem resolution for providers. Identifies and communicates trends that impact provider… more