- BronxCare Health System (Bronx, NY)
- …claims and audits of registration/insurance verification activities to improve denial rates and enhance revenue. In-service staff on Insurance ... participates in the Performance/Quality Improvement activities of the assigned department . Contribution and participation includes data collection, analysis, implementation… more
- BronxCare Health System (Bronx, NY)
- …Position Type Regular Full-Time Division Bronxcare Hospital Center - Concourse Shift Day Shift Department : Name Patient Financial Services (BHCS) ... Job LocationsUS-NY-Bronx ID2025-5671 Category Administrative/Clerical… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Utilization Management Specialist MSH Case Management FT Days** This position is responsible for coordinating requests for clinical ... and tracks concurrent adverse determinations and collaborates with Appeals Management Department in managing retrospective denials. **Qualifications** +… more
- Mount Sinai Health System (New York, NY)
- …processes appeals. Posts denials in IDX on a timely basis. + Provides comprehensive denial management to facilitate cash flow. Tracks, quantifies and reports on ... resolution to ensure accurate and timely payment of claims and collection. The Specialist works directly with the Department Administrator. Reports to Billing… more
- Nuvance Health (Danbury, CT)
- …Shifts Available- Days, Evenings, Nights available* *Summary:* The purpose of the Denial Prevention Nurse is to ensure that all patient admissions are appropriately ... the lack of a review may result in a denial , escalate to the appropriate Provider/VPMA. * Identify and...and communicating on a daily/regular basis with the Denials Management team. * Assists with informing Managed Care contracting… more
- Nuvance Health (Danbury, CT)
- …Responsible for the assigned areai? 1/2s claims submission, payment application, denial management , and account follow-up to ensure optimal reimbursement. ... 6. Adjusts account balances to specific account needs. 7. Maintains Contract Management reporting (ie, payment errors, carve out billings) and updates any… more
- Molina Healthcare (Yonkers, NY)
- …on denial decisions. * Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. * Identifies and reports ... a formal appeals request has been made or upon request by another Molina department to reduce the likelihood of a formal appeal being submitted. * Reevaluates… more
- City of New York (New York, NY)
- …is responsible for the organization, direction and supervision of the Case Management , Case Establishment, and the Case Support units which facilitate eligibility ... (FIA) is recruiting for one (1) Administrative Job Opportunity Specialist NM I, to function as Benefit Access Center...ensuring that Agency's requirements are met for opening, reopening, denial , closing, change in case status and change in… more