- Sedgwick (Rochester, NY)
- …Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Environmental Claims Specialist **Job Description Summary** To analyze complex or ... technically difficult environmental claims ; to provide resolution of highly complex nature and/or...provide resolution of highly complex nature and/or severe injury claims ; to coordinate case management within company standards, industry… more
- Insight Global (West Henrietta, NY)
- Job Description We are looking for a claims specialist ! Responsibilities include but are not limited to the following: Manages and identifies a portfolio of ... rejected claims to ensure maximum payer reimbursement and timely billing...eliminate financial risks Researches, analyzes and appropriately resolves rejected claims by working with national Medicare D plans, third… more
- Advantage Federal Credit Union (Rochester, NY)
- Asset Solutions Specialist About the Organization Advantage Federal Credit Union is a Not-for-Profit financial organization, wholly and locally owned and operated by ... charities and organizations. Location Metro Description The Asset Solution Specialist position works as a member of the Collections...as assigned + Debt Settlement related work - filing claims , follow up and applying payments + Filling out… more
- Molina Healthcare (Rochester, NY)
- …to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance ... and accurately, in accordance with regulatory requirements. + Research claims processing guidelines, provider contracts, fee schedules and system configurations… more
- Unither Pharmaceuticals (Rochester, NY)
- HR Specialist Who we are? We are a French pharmaceutical industrial group, recognized for making affordable healthcare products that improve and simplify patients' ... Resource & HSE Director, JOB SUMMARY: The Human Resource Specialist plays a critical role in supporting and assisting...to regulatory agencies when requested. + Process Workers Compensation Claims with handler, manage cases and leaves within the… more
- Walgreens (Canandaigua, NY)
- …and maintaining front end and pharmacy asset protection techniques, and filing claims for warehouse and vendor overages (merchandise received, but not billed), ... for non-returnable ABC overstock. Verifies posting of all pharmacy/ prescription claims . + Completes execution of all pricing activities including price changes,… more
- Gilead Sciences, Inc. (Rochester, NY)
- …the lives of patients with life-threatening illnesses worldwide. As a Prevention Specialist within Gilead's - Buffalo territory, you will represent Gilead's products ... and Drug Administration's implementing regulations, the Federal Anti-Kickback Statute, the False Claims Act, PhRMA, Corporate Code of Business Conduct and the Office… more
- Paychex (West Henrietta, NY)
- …prescribed guidelines to ensure good customer relations are maintained and customer claims and complaints are resolved fairly, effectively and in accordance with ... Paychex policies and procedures. Builds knowledge of the organization, processes, and customers. WORK SCHEDULE: Monday-Friday, 8:00am - 4:30pm local time *Schedule subject to change with transition of daylight savings time. Responsibilities + Delivers quality… more
- University of Rochester (Rochester, NY)
- …signatures for non-routine letters of correspondence related to appeals on denied claims . This includes compiling all necessary information and drafts for provider ... signature. - Manages provider(s) documentation and information. Composes and types non routine correspondence providing factual information. - Arranges travel, conference registration and hotel accommodations. Interfaces with organizations, hospitals and… more
- Paychex (Rochester, NY)
- …prescribed guidelines to ensure good customer relations are maintained and customer claims and complaints are resolved fairly, effectively and in accordance with ... Paychex policies and procedures. Builds knowledge of the organization, processes, and customers. Responsibilities + Delivers quality service as Account Manager to Paychex clients for Benefits Administration via phone, email, chat, and other avenues + Follows… more
- The Gleason Works (Rochester, NY)
- …the Logistics dashboard weekly. + Actively manage, analyze, and process Duty Drawback claims with assistance from the Logistics Clerk. + Must have a thorough ... knowledge and change awareness of applicable Customs regulations and expirations of rulings applicable to Duty Drawback. + Able to assist in safely packaging outbound orders for both parcel and LTL. + Prepare and maintain shipping documentation for both… more
- University of Rochester (Rochester, NY)
- …independent decisions as to the processes necessary to collect denied insurance claims and resolve billing issues. Must track payer/billing issues that affect ... reimbursement of claims and advising the management team of those trends...a nationally accredited billing program (ie, Certified Medical Billing Specialist CMBS, Certified Medical Records Technician CMRT, Certified Medical… more
- Oak Orchard Health (Brockport, NY)
- …the third-party billing organization to ensure proper processing of all payer claims . This would include research for accuracy, analyze reports, follow through ... the third-party billing company + Manage Accounts Receivable related to all claims and ensure reconciliation with the general ledger. This involves working closely… more
- University of Rochester (Rochester, NY)
- …and location. Correctly identifies diagnosis codes and charges are appropriate for claims to be effectively released and submitted to the assigned insurance ... carrier(s). - Troubleshoots any problems within billing system that prevents claims from being released for acceptance by insurance carrier(s). Identifies cause of… more
- Goodwill of the Finger Lakes (Rochester, NY)
- …environmental health and safety, workers compensation insurance program and claims , and all (CARF, OSHA, safety standards/regulations, etc..). Subscribes to ... safety and workers compensation programs. + Manages reporting process including section 110 claims . + Files all appropriate New York State forms (C-2, C-11 and… more
- University of Rochester (Rochester, NY)
- …Supervision and Direction Exercised: The Billing and Charge Correction Specialist is responsible for self-monitoring performance on assigned tasks, following ... correct dollar amount charged) to create compliant and billable claims for service. For professional billing: - Verify that...correct dollar amount charged) to create compliant and billable claims for service. - - Work with hospital PBB… more
- Lifetime Assistance, Inc. (Rochester, NY)
- …+ As directed, provides administrative coverage in the absence of the Benefits Specialist for administering Workers' Compensation claims as well as coverage for ... the Director of Human Resources. + Performs all other duties relevant to the position and notifies the Director of Human Resources of obstacles to achieving responsibilities. QUALIFICATION REQUIREMENTS: To perform this job successfully, an individual must be… more
- University of Rochester (Rochester, NY)
- …coding guidelines. - Reviews and resolves coding denials. Resolves problems with claims having errors related to improper coding and provides feedback for correction ... (RHIA) or (Registered Health Information Technician) RHIT or Certified Coding Specialist (CCS) preferred. - Or - Certified Professional Coder (CPC) from… more
- University of Rochester (Rochester, NY)
- …and training, licensure, work history, hospital affiliation history, malpractice claims history, board certification status, criminal background, evaluation of ... Professional Medical Services Management (CPMSM) and/or Certified Provider Credentialing Specialist (CPCS) preferred. **EOE Minorities / Females / Protected Veterans… more