• Clinical Denials & Appeals

    Northwell Health (Melville, NY)
    …needed. Preferred Skills 3-5 years experience in Utilization Review, Case Management, and Clinical Appeals . 3-5 years of acute inpatient clinical experience. ... with current state, federal, and third-party payer regulations. Ensures clinical reviews and appeals are up to date and accurately reflect patient's severity… more
    Northwell Health (10/11/25)
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  • Insurance Specialist -Mount Sinai…

    Mount Sinai Health System (New York, NY)
    Clinical /Technical/Service** + Demonstrates the ability to perform clinical /technical/service/administrative tasks: + Prioritizes Insurance Requests / Denials ... **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days...Appeals Nurse / Manager by confirming status of denials + Tracking status of Medical Record requests for… more
    Mount Sinai Health System (07/23/25)
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  • Utilization Management Specialist -MSH-Case…

    Mount Sinai Health System (New York, NY)
    …facilitates and tracks concurrent adverse determinations and collaborates with Appeals Management Department in managing retrospective denials . ... **Job Description** **Utilization Management Specialist MSH Case Management FT Days** This position...Days** This position is responsible for coordinating requests for clinical information from third party payers and providing support… more
    Mount Sinai Health System (10/03/25)
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  • Utilization Review Specialist

    BriteLife Recovery (Englewood, NJ)
    clinical information and advocating for appropriate levels of care. The UR Specialist works closely with clinical staff, admissions, medical providers, and ... What you will be doing? The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is responsible for… more
    BriteLife Recovery (10/04/25)
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  • Billing Specialist

    Performance Optimal Health (Stamford, CT)
    …through exceptional care, service, and teamwork. We are seeking a Billing Specialist to join our growing Practice Administration/Billing team. This role combines all ... authorizations/pre-certifications as required by payers. + Resolve billing issues, denials , and underpayments by following up with insurance companies, patients,… more
    Performance Optimal Health (10/12/25)
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