University of Rochester

University of Rochester, located on the banks of the Genesee River in Rochester, New York, is a four-year private institution of higher learning that has offere

Clm Resltion Rep III, Hosp/Prv

Location

New York

Posted

5 days ago

Salary

$20 - $27 / hour

Seniority

Senior

Associate Degree

Job Description

Clm Resltion Rep III, Hosp/Prv

University of Rochester

Title: Clm Resltion Rep III, Hosp/Prv Location: Rochester Technology Park Job Description: As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. Job Location (Full Address): Remote Work - New York, Albany, New York, United States of America, 12224 Opening: Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 910402 United Business Office Work Shift: UR - Day (United States of America) Range: UR URCA 205 H Compensation Range: $20.30 - $27.41 The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations. Responsibilities: GENERAL PURPOSE The Claims Resolution Representative III is responsible for working across the professional fee organization, handling follow-up activities designed to bring all open accounts receivable to successful closure. Responsible for effective claims follow-up on complex, multi-faceted accounts to obtain maximum revenue collection and closure. Responsibilities include, but are not limited to, independent research, claim correction and resubmission, handling payer specific appeal process taking timely and routine action to resolve unpaid claims. The Claims Resolution Representative III reports to Accounts Receivable Management. ESSENTIAL FUNCTIONS With general direction of the Manager/Supervisor/Lead: 40% Follows department policies and procedures and maintains and exercises comprehensive knowledge of insurance company billing requirements and regulations to research and resolve unpaid accounts receivable, making any corrections in the professional billing system necessary to ensure balance resolution for all assigned URMFG physician services. 25% Follows up on multi-faceted denials through review of remittances (EOBs), insurance correspondence, rejections received thru daily electronic and claims submission, etc. - Research claims, identify problems, and take appropriate action to assure claim resolution. 20% Responds to all billing-related inquiries from colleagues, departments, patients, and payors in a timely and professional manner. - Communicates any missing/incomplete information to providers and department administrative support staff to ensure accurate billing. - Communicates with insurance representatives through telephone calls, payer website, and written communication to ensure accurate processing of claims. - Collaborate with appropriate departments to generate a detailed rational for appeals and grievances to the insurance companies. 10% Keeps management informed of changes in billing requirements and rejection or denial codes as they pertain to claim processing and coding. - Escalates system issues preventing claims submission and follow-up for review and resolution. 5% Collaborates with Claim Edit Specialists and Patient Medical Billing Specialists assigned to pre claim WQ’s to identify opportunities for improvement in clean claims rate. May perform other duties as assigned. QUALIFICATIONS Required: - Associate degree and 2 years of related relevant experience; or equivalent combination of education and/or experience - Excellent problem-solving skills - Excellent communication skills - Excellent customer service skills Preferred: - Strong working knowledge of the professional billing software applications - Ability to type 25 wpm. The University of Rochester is committed to fostering, cultivating, and preserving an inclusive and welcoming culture to advance the University’s Mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion, creed, sex, sexual orientation, citizenship status, or any other characteristic protected by federal, state, or local law (Protected Characteristics). This commitment extends to non-discrimination in the administration of our policies, admissions, employment, access, and recruitment of candidates, for all persons consistent with our values and based on applicable law.

Related Categories

Related Job Pages

More Business Development Rep Jobs

Claim Resolution Representative II

University of Rochester

University of Rochester, located on the banks of the Genesee River in Rochester, New York, is a four-year private institution of higher learning that has offere

Title: Clm Resltion Rep III, Hosp/Prv remote type Hybrid locations Rochester - NY Rochester Technology Park time type Full time job requisition id R267020 Job Description: As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. Job Location (Full Address): Remote Work - New York, Albany, New York, United States of America, 12224 Opening: Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 910402 United Business Office Work Shift: UR - Day (United States of America) Range: UR URCA 205 H Compensation Range: $20.30 - $27.41 The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations. Responsibilities: GENERAL PURPOSE The Claims Resolution Representative III is responsible for working across the professional fee organization, handling follow-up activities designed to bring all open accounts receivable to successful closure. Responsible for effective claims follow-up on complex, multi-faceted accounts to obtain maximum revenue collection and closure. Responsibilities include, but are not limited to, independent research, claim correction and resubmission, handling payer specific appeal process taking timely and routine action to resolve unpaid claims. The Claims Resolution Representative III reports to Accounts Receivable Management. ESSENTIAL FUNCTIONS With general direction of the Manager/Supervisor/Lead: - 40% Follows department policies and procedures and maintains and exercises comprehensive knowledge of insurance company billing requirements and regulations to research and resolve unpaid accounts receivable, making any corrections in the professional billing system necessary to ensure balance resolution for all assigned URMFG physician services. - 25% Follows up on multi-faceted denials through review of remittances (EOBs), insurance correspondence, rejections received thru daily electronic and claims submission, etc. Research claims, identify problems, and takes appropriate action to assure claim resolution. - 20% Responds to all billing-related inquiries from colleagues, departments, patients, and payors in a timely and professional manner. Communicates any missing/incomplete information to providers and department administrative support staff to ensure accurate billing. Communicates with insurance representatives through telephone calls, payer website, and written communication to ensure accurate processing of claims. Collaborate with appropriate departments to generate a detailed rational for appeals and grievances to the insurance companies. - 10% Keeps management informed of changes in billing requirements and rejection or denial codes as they pertain to claim processing and coding. Escalates system issues preventing claims submission and follow-up for review and resolution. - 5% Collaborates with Claim Edit Specialists and Patient Medical Billing Specialists assigned to pre claim WQ’s to identify opportunities for improvement in clean claims rate. May perform other duties as assigned. QUALIFICATIONS Required: - Associate degree and 2 years of related relevant experience; or equivalent combination of education and/or experience - Excellent problem-solving skills - Excellent communication skills - Excellent customer service skills Preferred: - Strong working knowledge of the professional billing software applications - Ability to type 25 wpm. The University of Rochester is committed to fostering, cultivating, and preserving an inclusive and welcoming culture to advance the University’s Mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion, creed, sex, sexual orientation, citizenship status, or any other characteristic protected by federal, state, or local law (Protected Characteristics). This commitment extends to non-discrimination in the administration of our policies, admissions, employment, access, and recruitment of candidates, for all persons consistent with our values and based on applicable law.

New York
$20 - $27 / hour
Thoughtworks logo

Business Development Executive

Thoughtworks

Thoughtworks is a dynamic and inclusive community of bright and supportive colleagues who are revolutionizing tech. As a leading technology consultancy, we’re pushing boundaries through our purposeful and impactful work. Over 30 years of delivering extraordinary impact with clients. Helping clients solve complex business problems with technology as the differentiator.

Full TimeRemoteTeam 10,001

Role Description Thoughtworks is seeking business development leaders to join and lead our client growth in the Americas region. Business Development Executives at Thoughtworks are responsible for developing and securing a pipeline of new opportunities and building relationships with both new clients and in new areas of existing client organizations. As a Business Development Executive you are responsible for: - Prospecting, identifying and qualifying new opportunities. - Building trust with potential clients. - Shaping deals and developing winning value propositions. - Tightly orchestrating sales pitches, proposals and orals. - Negotiating win/win agreements with prospective clients. - Expanding follow-on sales to create a sustainable business within each account. - Working across client organizations, from C-level and board members to front line business and technical staff. To be successful, you will have: - Multiple years of consultative selling experience within an enterprise IT services company. - Experience demonstrating industry relevance and expertise across one or more industry domains. - Sold custom software application development and digital transformation services. - Demonstrated proficiency in prospecting, leading and securing custom software and digital transformation deals with significant total contract value (TCV). - Expertise dealing with both business and IT leaders and executives. As a seasoned industry executive, you have: - Spent your career enabling clients to solve complex challenges and achieve meaningful business outcomes. - Cultivated trusted relationships across the C-suite and executive levels of key enterprises within your domain. - Used your industry-specific network and insight to articulate our differentiated value proposition. - Deep contextual understanding of the industry’s trends, challenges, and innovation priorities. Qualifications - Over 15 years of applicable experience and a “hunter” mentality with multi-industry experience. - Proven track record in lead prospecting, opportunity development, deal shaping, relationship building, negotiation, and commercial acumen. - Technology and consulting expertise with the ability to translate client pain points into solutions that drive business value. - Ability to sell high-value business solutions beyond commoditized services and staff augmentation. - Experience leading complex sales cycles, including RFPs, multi-stakeholder negotiations, and deal structuring. - Gravitas and experience in engaging C-level stakeholders using a consultative selling approach. - Deep understanding of technology trends, cloud solutions, AI, and agile methodologies. - An entrepreneurial drive and spirit. Requirements - Build and develop a robust sales pipeline of ~3X qualified sales opportunity pipeline. - Work closely with delivery teams, solution architects, and marketing to tailor offerings to client needs. - Partner with alliances and ecosystem partners (e.g., AWS, Microsoft, Google Cloud) to drive joint sales opportunities. Benefits - Learning & Development: Interactive tools, numerous development programs, and supportive teammates. - Responsible Use of AI in Recruitment: AI tools support administrative tasks, but do not screen or make hiring decisions. Company Description Thoughtworks is a dynamic and inclusive community of bright and supportive colleagues who are revolutionizing tech. As a leading technology consultancy, we’re pushing boundaries through our purposeful and impactful work. For 30+ years, we’ve delivered extraordinary impact together with our clients by helping them solve complex business problems with technology as the differentiator.

Americas
$242K - $466K / year
Job Closed
Mamoru logo

Business Development Manager

Mamoru

Empowering your finances with ease

Full TimeRemoteTeam 51-200Since 2020H1B No Sponsor

• Assist the setup of local entity, FX broker accounts, exchange accounts, and onboard with payment processors. • Work closely with global operation team for the local operation • As a local representative, building up the relationship with banks, brokers, exchanges, merchants and payment processors • Develop FX trading business targeting HNW investors, institutional investors or merchants, and individual traders in the local market • Proactively stay up to date about market trends, opportunities, risk and new projects, with a passion for the FX payments industry • Appoint as nominee director of the local entity • Handle local company’s administrative tasks

Uganda
CluneTech logo

Business Development Manager – SAP MBC Embedded Payments

CluneTech

CluneTech is a suite of companies providing industry-leading solutions that make business better #BestWorkplaces25

Full TimeRemoteTeam 1,001-5,000Since 1996H1B No Sponsor

• You will be responsible for driving our Embedded Payments business with SAP • Drive new business for SAP Embedded Payments, from lead generation to contract closure • Engage CFOs, treasury leaders, IT heads, and transformation teams to understand banking, payments, and connectivity needs • Build compelling MBC value propositions highlighting integration simplification, security, and automation • Collaborate with presales and solution architects to craft accurate solution scopes and pricing • Manage the full pipeline with disciplined forecasting and deal progression • Develop relationships with SAP, banking partners, system integrators, and fintech ecosystem players • Provide market insights to refine GTM strategy for corporate treasury and payment connectivity • Represent the organization at SAP, treasury, and fintech events

United States