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Medical information specialist Jobs in Rochester, NY

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Medical information specialist • rochester ny

Last updated: 16 hours ago
  • Promoted
Medical Management Specialist

Medical Management Specialist

Erie Insurance GroupRochester, NY, US
Full-time
Do you have a passion for helping people through the claims process, especially when medical recovery and compassion matter most? Erie Insurance is seeking a Medical Management Specialist to join o...Show moreLast updated: 5 days ago
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  • New!
Medical Assistant - Hilton Family Medical

Medical Assistant - Hilton Family Medical

NY StaffingHilton, NY, US
Full-time
Summary : As a Medical Assistant, you are a non-licensed health care provider who, under the direction and supervision of a licensed health care provider, delivers direct and indirect patient care.Y...Show moreLast updated: 16 hours ago
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Medical Doctor

Medical Doctor

Tend HealthRochester, NY, US
Full-time
Physician (New York) – Telehealth Mental Health for Healthcare Professionals.Location : Remote (Telehealth – New York - Must reside in or have physical address in New York). Position Type : (2-8 hrs / w...Show moreLast updated: 24 days ago
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Information Architect

Information Architect

TradeJobsWorkForce14625 Rochester, NY, US
Full-time
Information Architect Job Duties : Identifies user requirements by researching and analyzing user needs, ...Show moreLast updated: 30+ days ago
Medical Management Specialist

Medical Management Specialist

Erie InsuranceRochester, US
Full-time
Division or Field Office : New York Branch Office Department of Position : Claims Department Work from : Rochester NY office Salary Range : $51,806.This range represents ...Show moreLast updated: 6 days ago
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Information Systems Technician

Information Systems Technician

U.S. NavyScottsville, NY, United States
Full-time
ABOUT Effective, secure communication in the cyber domain is essential to the everyday operations of military intelligence in America’s Navy. Information Professionals who oversee the seamless opera...Show moreLast updated: 10 days ago
Information Technology Technician

Information Technology Technician

New York Western District CourtRochester, NY, US
Full-time
Job Details for Information Technology Technician.Court Name / Organization : New York Western District Court Overview of the Position : The U. District Court and Probation Office for the Western Distri...Show moreLast updated: 30+ days ago
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Senior Analyst, Configuration Information Management- NetworX

Senior Analyst, Configuration Information Management- NetworX

Molina HealthcareRochester, NY, United States
Full-time
Serves as a subject matter expert on system capabilities, conducting research and root cause analysis to resolve complex business and technical issues. Ensures system configuration aligns with busin...Show moreLast updated: 3 days ago
Medical Billing Specialist

Medical Billing Specialist

Robert HalfRochester, NY, United States
Permanent
Description We are looking for a skilled Medical Billing Specialist to join our team in Rochester, New York.This Contract to permanent position offers an opportunity to contribute to a dynamic heal...Show moreLast updated: 30+ days ago
Information Technology - IT Internship

Information Technology - IT Internship

Episcopal SeniorLife CommunitiesRochester, New York
Internship
Job Type Internship Description.Episcopal SeniorLife Communities Mission : .We provide high quality services from skilled nursing and restorative care to housing, assisted living and community-based ...Show moreLast updated: 30+ days ago
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MEDICAL IMAGING SPECIALIST

MEDICAL IMAGING SPECIALIST

eHealth Global TechnologiesRochester, NY, US
Full-time
This is an onsite position in our Fairport, NY office.Health Technologies is a leading healthcare technology company that advances the delivery of life-altering care. Since 2006, we have decreased t...Show moreLast updated: 1 day ago
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Chief Information Security Officer

Chief Information Security Officer

Sword HealthRochester, NY, US
Full-time
Chief Information Security Officer.Sword Health is on a mission to free two billion people from pain.With 67% of members achieving a pain-free life and a 70% reduction in surgery intent, at Sword, ...Show moreLast updated: 10 days ago
Customer Service Specialist / Medical Insurance Billing

Customer Service Specialist / Medical Insurance Billing

Fonte Surgical Supply, Inc.Rochester, New York, United States
Full-time +1
Quick Apply
As a Customer Service Specialist.Must be motivated, willing to learn, and interact with our customers with a positive attitude. We will train the qualified candidate to succeed in all aspects of the...Show moreLast updated: 26 days ago
Information Governance Specialist

Information Governance Specialist

Cravath, Swaine & MooreNY, US
Full-time
The Information Governance Specialist is responsible for maintaining active client and administrative records, both electronic and hard copy, under general direction from department management.Perf...Show moreLast updated: 30+ days ago
Health Information Specialist

Health Information Specialist

VirtualVocationsRochester, New York, United States
Full-time
A company is looking for a Health Information Specialist.Key Responsibilities Analyzes medical records to identify deficiencies and assigns them to appropriate health care providers for completen...Show moreLast updated: 30+ days ago
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Medical Billing - Payment Posting Specialist

Medical Billing - Payment Posting Specialist

Elizabeth Wende Breast CareRochester, NY, United States
Full-time
Medical Billing - Payment Posting Specialist Job Description.Since 1975, Elizabeth Wende Breast Center has been serving the greater Rochester, NY area with superior breast imaging technology and pa...Show moreLast updated: 4 days ago
Intern, Information Technology

Intern, Information Technology

Constellation BrandsRochester, New York
Full-time
The Intern is responsible for performing a variety of professional IT work at a growing Fortune 500 company.We are hiring in the follow areas : Information Security, Data & Analytics, Finance Resour...Show moreLast updated: 30+ days ago
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Tax Director - Global Information Reporting

Tax Director - Global Information Reporting

PwCRochester, NY, United States
Full-time
At PwC, our people in finance consulting specialise in providing consulting services related to financial management and strategy. These individuals analyse client needs, develop financial solutions...Show moreLast updated: 12 days ago
Information Technology - Project Manager

Information Technology - Project Manager

Rochester Regional HealthRiedman Campus
Full-time
As a Project Manager, your statistical experience and outstanding ability to lead and manage multifaceted projects along with your exceptional organization and time management skills allow for succ...Show moreLast updated: 30+ days ago
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Medical Management Specialist

Medical Management Specialist

Erie Insurance GroupRochester, NY, US
5 days ago
Job type
  • Full-time
Job description

Medical Management Specialist

Do you have a passion for helping people through the claims process, especially when medical recovery and compassion matter most? Erie Insurance is seeking a Medical Management Specialist to join our New York Branch team in Rochester. This position plays a vital role in handling first-party medical benefit claims and ensuring our policyholders receive the care and support they deserve.

There is a potential for multiple positions to be available.

What You'll Do

  • Manage first-party medical benefit claims, including wage loss and fatality claims.
  • Investigate coverage, determine claim value, and ensure compliance with applicable state laws.
  • Analyze medical records and wage documentation to reach fair, accurate claim conclusions.
  • Collaborate with legal counsel on litigation cases and coordinate with investigative services when necessary.
  • Maintain contact with policyholders, claimants, agents, and medical providers to deliver outstanding service.
  • Assist in training branch staff and stay current on laws and medical management best practices.

Who You Are

You're detail-oriented, empathetic, and confident managing complex medical claim situations. You combine strong analytical skills with a calm, professional approach to resolving claims efficiently and fairly.

Within designated authority, handles medical management claims with limited supervision.

Duties and Responsibilities

  • Handles first party medical benefit claims, including fatalities and wage loss claims. Evaluates and makes decisions regarding coverage. Conducts investigations, determines total value of claims, sets and maintains adequate reserves, and manages cases.
  • Prepares related correspondence and reports, obtains medical and employment related records, calculates wage loss claims per applicable state laws and brings claims to conclusion.
  • Investigates, evaluates, and resolves coverage questions in compliance with applicable state laws.
  • Establishes immediate contact with Policyholders and Claimants. Contacts Agents as necessary.
  • Reviews claim files on a regular basis and takes necessary follow-up and / or closing action.
  • Evaluates, processes and takes appropriate action on claim-related bills and medical, rehabilitation and special investigative reports. Determines claims to be paid, compromised or contested.
  • Coordinates activities with the Home Office on serious or massive injury cases. Notifies company investigative services of cases involving suspected fraud.
  • When appropriate manages claims in litigation and assist in the development of case strategy with legal counsel.
  • Duties and Responsibilities (cont'd if applicable)

  • Attends industry-related training programs to stay current on legal developments and ensure compliance with applicable laws and regulations impacting the operation of the department.
  • Assists or acts on the behalf of supervisor when required, including handling of insurance department complaints.
  • When appropriate identifies subrogation situations and initiates appropriate action.
  • Develops expertise in legal and medical terminology and procedures.
  • Assists in training branch office personnel in related matters.
  • Assigns, monitors and controls activities of vendors in a cost-effective manner.
  • The first five duties listed are the functions identified as essential to the job. Essential functions are those job duties that must be performed in order for the job to be accomplished. This position description in no way states or implies that these are the only duties to be performed by the incumbent. Employees are required to follow any other job-related instruction and to perform any other duties as requested by their supervisor, or as become evident.

    Capabilities

  • Values Diversity
  • Job-Specific Knowledge
  • Self-Development
  • Nimble Learning
  • Collaborates
  • Customer Focus
  • Cultivates Innovation
  • Optimizes Work Processes (IC)
  • Instills Trust
  • Ensures Accountability
  • Decision Quality
  • Qualifications

    Minimum Educational Requirements

  • High School Diploma or GED and two years of general claims handling experience required, or;
  • Bachelor's Degree required.
  • OR completion of formal ERIE training program, required.
  • Additional Experience

  • Strong working knowledge of applicable state laws preferred.
  • Good working knowledge of human anatomy and medical terminology preferred.
  • Expertise in state no-fault laws and working knowledge of civil law preferred.
  • Working knowledge of medical bill repricing system preferred.
  • Designations and / or Licenses

  • Successful completion of AIC courses preferred.
  • Appropriate license as required by state.
  • Physical Requirements

  • Lifting / Moving 0-20 lbs; Occasional (
  • Lifting / Moving 20-50 lbs; Occasional (
  • Ability to move over 50 lbs using lifting aide equipment; Occasional (
  • Driving; Rarely
  • Pushing / Pulling / moving objects, equipment with wheels; Occasional (
  • Manual Keying / Data Entry / inputting information / computer use; Often (20-50%)
  • Climbing / accessing heights; Rarely