Claim Resolution Representative III Job at University of Rochester (Albany)

New

Claim Resolution Representative III

As a community, the University of Rochester is defined by a deep commitment to M...

Location

United States of America , Rochester

Salary:

19.62 - 26.49 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

Associate's degree and 2 years of relevant experience required
Or equivalent combination of education and experience

Job Responsibility

Performs follow-up activities designed to bring all open account receivables to successful closure
Responsible for an effective claims follow-up to obtain maximum revenue collection
Researches, corrects, resubmits claims, submits appeals and takes timely and routine action to resolve unpaid claims
Resolves complex claims
Acts as a resource for lower level staff
Completes follow up activities on denied, unpaid, or underpaid accounts
Contacts payer representatives to research and resubmit rejected claims to obtain and verify insurance coverage
Follows up on unpaid accounts working claims
Reviews reasons for claim denial
Reviews payer website or contacts payer representatives to determine why claims are not paid

Fulltime

New

Claim resolution representative iii

As a community, the University of Rochester is defined by a deep commitment to M...

Location

United States of America , Rochester

Salary:

19.62 - 26.49 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

Associate's degree and 2 years of relevant experience required
Or equivalent combination of education and experience

Job Responsibility

Performs follow-up activities designed to bring all open account receivables to successful closure
Responsible for an effective claims follow-up to obtain maximum revenue collection
Researches, corrects, resubmits claims, submits appeals and takes timely and routine action to resolve unpaid claims
Resolves complex claims
Acts as a resource for lower level staff
Completes follow up activities on denied, unpaid, or underpaid accounts, as well as contacts payer representatives to research and resubmit rejected claims to obtain and verify insurance coverage
Follows up on unpaid accounts working claims
Reviews reasons for claim denial
Reviews payer website or contacts payer representatives to determine why claims are not paid
Determines steps necessary to secure payment and completes and documents follow up by resubmitting claim or deferring tasks

Fulltime

New

Claim Resolution Representative III, Hospital/Private

As a community, the University of Rochester is defined by a deep commitment to M...

Location

United States of America , Albany

Salary:

19.62 - 26.49 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

Associate's degree and 2 years of relevant experience required
Or equivalent combination of education and experience

Job Responsibility

Performs follow-up activities designed to bring all open account receivables to successful closure
Responsible for an effective claims follow-up to obtain maximum revenue collection
Researches, corrects, resubmits claims, submits appeals and takes timely and routine action to resolve unpaid claims
Resolves complex claims
Acts as a resource for lower level staff
Completes follow up activities on denied, unpaid, or underpaid accounts, as well as contacts payer representatives to research and resubmit rejected claims to obtain and verify insurance coverage
Follows up on unpaid accounts working claims
Reviews reasons for claim denial
Reviews payer website or contacts payer representatives to determine why claims are not paid
Determines steps necessary to secure payment and completes and documents follow up by resubmitting claim or deferring tasks

Fulltime

New

Claim Resolution Representative III, Hospital/Private

As a community, the University of Rochester is defined by a deep commitment to M...

Location

United States of America , Rochester

Salary:

19.62 - 26.49 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

Associate's degree and 2 years of relevant experience required
Or equivalent combination of education and experience

Job Responsibility

Performs follow-up activities designed to bring all open account receivables to successful closure
Responsible for an effective claims follow-up to obtain maximum revenue collection
Researches, corrects, resubmits claims, submits appeals and takes timely and routine action to resolve unpaid claims
Resolves complex claims
Acts as a resource for lower level staff
Completes follow up activities on denied, unpaid, or underpaid accounts, as well as contacts payer representatives to research and resubmit rejected claims to obtain and verify insurance coverage
Follows up on unpaid accounts working claims
Reviews reasons for claim denial
Reviews payer website or contacts payer representatives to determine why claims are not paid
Determines steps necessary to secure payment and completes and documents follow up by resubmitting claim or deferring tasks

Fulltime

New

Claim Resolution Representative III

As a community, the University of Rochester is defined by a deep commitment to M...

Location

United States of America , Rochester

Salary:

19.62 - 26.49 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

Associate's degree and 2 years of relevant experience required
Or equivalent combination of education and experience

Job Responsibility

Performs follow-up activities designed to bring all open account receivables to successful closure
Responsible for an effective claims follow-up to obtain maximum revenue collection
Researches, corrects, resubmits claims, submits appeals and takes timely and routine action to resolve unpaid claims
Resolves complex claims
Acts as a resource for lower-level staff
Completes follow up activities on denied, unpaid, or underpaid accounts, as well as contacts payer representatives to research and resubmit rejected claims to obtain and verify insurance coverage
Follows up on unpaid accounts working claims
Reviews reasons for claim denial
Reviews payer website or contacts payer representatives to determine why claims are not paid
Determines steps necessary to secure payment and completes and documents follow up by resubmitting claim or deferring tasks

Fulltime

New

Claim Resolution Representative III, Hospital/Private

As a community, the University of Rochester is defined by a deep commitment to M...

Location

United States of America , Rochester

Salary:

19.62 - 26.49 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

Associate's degree and 2 years of relevant experience required
Or equivalent combination of education and experience

Job Responsibility

Performs follow-up activities designed to bring all open account receivables to successful closure
Responsible for an effective claims follow-up to obtain maximum revenue collection
Researches, corrects, resubmits claims, submits appeals and takes timely and routine action to resolve unpaid claims
Resolves complex claims
Acts as a resource for lower-level staff
Completes follow up activities on denied, unpaid, or underpaid accounts, as well as contacts payer representatives to research and resubmit rejected claims to obtain and verify insurance coverage
Follows up on unpaid accounts working claims
Reviews reasons for claim denial
Reviews payer website or contacts payer representatives to determine why claims are not paid
Determines steps necessary to secure payment and completes and documents follow up by resubmitting claim or deferring tasks

Fulltime

New

Claim Resolution Rep III

As a community, the University of Rochester is defined by a deep commitment to M...

Location

United States of America , Rochester

Salary:

19.62 - 26.49 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

Associate's degree and 2 years of relevant experience required
Or equivalent combination of education and experience

Job Responsibility

Performs follow-up activities designed to bring all open account receivables to successful closure
Responsible for an effective claims follow-up to obtain maximum revenue collection
Researches, corrects, resubmits claims, submits appeals and takes timely and routine action to resolve unpaid claims
Resolves complex claims
Acts as a resource for lower level staff
Completes follow up activities on denied, unpaid, or underpaid accounts, as well as contacts payer representatives to research and resubmit rejected claims to obtain and verify insurance coverage
Follows up on unpaid accounts working claims
Reviews reasons for claim denial
Reviews payer website or contacts payer representatives to determine why claims are not paid
Determines steps necessary to secure payment and completes and documents follow up by resubmitting claim or deferring tasks

Fulltime

New

Claims Resolution Representative III

The Claims Resolution Representative III is responsible for working across the p...

Location

United States of America , Rochester

Salary:

19.62 - 26.49 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

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

Job Responsibility

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
Follows up on multi-faceted denials through review of remittances (EOBs), insurance correspondence, rejections
Research claims, identify problems, and take appropriate action to assure claim resolution
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
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
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

Fulltime

Claim Resolution Representative III

University of Rochester

Location:
United States of America , Albany

Category:
Finance

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:
February 21, 2026

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Location:United States of America , Albany

Category:Finance

Contract Type:Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:February 21, 2026

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Contract Type:
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Job Posted:
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