LogoFresh Jobs Ahead
Independent Health
Independent Health
1 001 – 5 000 Darbuotojai
H1B vizos rėmėjasDraudimasSveikatos draudimasSveikatos priežiūra
„Independent Health“ yra Vakarų Niujorke veikianti sveikatos draudimo organizacija ir viena pirmųjų regiono sveikatos priežiūros organizacijų (HMO). Ji teikia draudimo apsaugą ir susijusias paslaugas maždaug 355 000 žmonių, siūlydama daugiau kaip 100 planų, produktų ir paslaugų. Organizacijos veikla apima komercinį sveikatos draudimą, vaistų išmokas, „Medicare Advantage“ ir savarankiškai finansuojamus sveikatos planus. Bendrovė savo kultūrą apibūdina kaip orientuotą į pagalbą nariams ir darbuotojams, kad jie galėtų atskleisti geriausias savo savybes.
LinkedIn
Darbai įmonėje

Claims Adjudicator – Medical and Dental Claims

Process medical and dental claims for Nova Healthcare Administrators, reviewing payments, coding, benefits, and customer questions. This hybrid role requires onsite attendance in Williamsville as needed.

USJungtinės ValstijosNYNiujorkas
19 $ / valanda
HibridinisVisas etatasJaunesnysis specialistasDiplomas nebūtinasPrivaloma Kalba: anglųBendra

Aprašymas

  • Assess and adjust medical and dental claims using established criteria and client plan documents.
  • Address client, member, and provider questions about claim status, benefit design, and payments alongside Customer Service Representatives.
  • Process facility, professional, member-submitted, pharmacy, and dental claim edits for in-network and out-of-network benefits.
  • Review vouchers and payment explanations to find and resolve claim issues.
  • Meet departmental targets for output, accuracy, policy and procedure knowledge, and timely processing.
  • Investigate policy, payment, and coding matters.
  • Keep knowledge of contracts, summary plan descriptions, and benefits up to date.
  • Apply critical thinking when processing claims.
  • Use systems and applications to find details specific to each claim.
  • Find, interpret, and apply resources to individual claim scenarios.
  • Spot and communicate opportunities to improve processes.
  • Organize and prioritize claim-processing work.
  • Work with other Independent Health departments to resolve claim payment problems.
  • Attend the Williamsville office when required.

Reikalavimai

  • A high school diploma is required.
  • A medical office assistant certificate and/or college degree is preferred.
  • At least six months of medical claims processing or medical billing experience, customer service experience preferably in healthcare or social services, or an equivalent combination of experience.
  • Knowledge of medical billing procedures.
  • Knowledge of CPT and ICD-9 coding.
  • Knowledge of medical terminology.
  • Data entry proficiency and familiarity with Microsoft Office products.
  • Strong organizational skills, attention to detail, and follow-through.
  • Strong written, verbal, and interpersonal communication skills.
  • Ability to communicate effectively with internal and external customers.
  • Ability to work collaboratively.
  • Flexibility to work additional hours as needed.
  • Examples of demonstrating Nova’s Core 4: Act with Passion, Work Together, Be Accountable, and Build Trust.
  • Ability to meet departmental deadlines and turnaround times and comply with state and federal regulations.
  • Immigration or work visa sponsorship is not provided.

Privalumai

  • First-class perks and benefits.
  • Eligibility for scorecard incentives.
  • A full range of benefits.
  • Generous paid time off.
  • Hybrid work arrangement.

Susiję darbai

Overlake Medical Center & Clinics

Patient Access Scheduling Coordinator

Overlake Medical Center & Clinics
1 001 – 5 000 Darbuotojai
Gera savijautaNe pelno organizacijosSveikatos priežiūra
USJungtinės Valstijos
28 $ – 42 $ / valanda
HibridinisVisas etatasJaunesnysis specialistasDiplomas nebūtinasPrivaloma Kalba: anglųBendraPacientų koordinatorius

Coordinate specialty, hospital, and ancillary referrals and appointments at Overlake Medical Center & Clinics. The role includes patient notifications, records coordination, and referral follow-up.

Atidaryti
Allied Physicians Group

Medical Receptionist, Pediatrics — Allied Physicians Group

Allied Physicians Group
501 – 1 000 Darbuotojai
Sveikatos priežiūra
USJungtinės ValstijosNYNiujorkas
20 $ – 23 $ / valanda
HibridinisVisas etatasJaunesnysis specialistasDiplomas nebūtinasPrivaloma Kalba: anglųBendraMedicinos registratorius

Welcome patients and coordinate appointments, insurance, and front-desk support for Allied Physicians Kids Care Pediatrics. Travel between the Elmont and Lynbrook offices as operational needs require.

Atidaryti
Healthfirst

Clinical Coding Retrieval Coordinator

Healthfirst
1 001 – 5 000 Darbuotojai
H1B vizos rėmėjasDraudimasSveikatos draudimasSveikatos priežiūra
USJungtinės ValstijosCTKonektikutasNJNaujasis DžersisNYNiujorkasPAPensilvanija
68 900 $ – 99 620 $ / metai
HibridinisVisas etatasJaunesnysis specialistasVidutinis lygisDiplomas nebūtinasPrivaloma Kalba: anglųBendraKlinikinis koordinatorius
SOAP

Coordinate medical record retrieval and review for Healthfirst’s RADV risk adjustment and compliance programs. Work with providers and internal teams to track audits, meet deadlines, and protect HIPAA-regulated documentation.

Atidaryti