- Catholic Health Services (Melville, NY)
- …Health was named Long Island's Top Workplace! Job Details The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and appeals ... and/or escalates denial when appropriate. + Submits all (initial and/or appeals ) reviews and/or letters within contractual or regulatory timeframes. + Collaborates… more
- BronxCare Health System (Bronx, NY)
- …the analysis and preparation of responses to payor denials and develop strong appeals for the purpose of securing reimbursement for acute care services provided to ... identification of patterns and trends identified during the course of appeals preparation. Conduct departmental performance improvement audits, analyze findings and… more
- Catholic Health Services (Melville, NY)
- …services and coordinates utilization/ appeals management review. + Assist Utilization and Appeals Manager in setting up communications with payors and/ or ... facility departments. + Develops/validates daily work lists for Utilization and Appeals Manager . + Assist with all insurance and regulatory audits and provides… more
- Molina Healthcare (Buffalo, NY)
- …for leading, organizing and directing the activities of the Grievance and Appeals Unit that is responsible for reviewing and resolving member and provider ... Manages staff responsible for the submission/resolution of member and provider inquiries, appeals and grievances for the Plan. Ensures resolutions are compliant. +… more
- Mount Sinai Health System (New York, NY)
- …as per department protocol (IPRO Discharge Appeals / Insurance requests) + Support Appeals Nurse / Manager by confirming status of denials + Tracking status ... + Requests or provides Medical Records as required for appeals , On / Off-site Insurance reviews + Implements.../ Off-site Insurance reviews + Implements first step of appeals process to assist Appeals Nurse and… more
- New York State Civil Service (Albany, NY)
- …Duties Description Under the direction of the Clerk of the Court, the Building Manager oversees maintaining the Court of Appeals building and grounds and courier ... service in the Court of Appeals . The Building Manager supervises and coordinates the twenty-four hours, seven days a week maintenance activity and performs other… more
- Garnet Health (Middletown, NY)
- …for the day to day operation of the CDI department and DRG Denials appeals process. The Manager will develop, implement and evaluate processes, policies and ... Administrator, Coding & Clinical Documentation Improvement and Patient Access, the Manager of Clinical Documentation Integrity (CDI) and DRG Denials is responsible… more
- Molina Healthcare (Buffalo, NY)
- …for leading, organizing and directing the activities of the Grievance and Appeals Unit that is responsible for reviewing and resolving member complaints and ... * Leads, organizes, and directs the activities of the Appeals & Grievances unit that is responsible for reviewing... and grievance processing/resolution, including 2 years in a manager role. * Experience reviewing all types of medical… more
- CenterWell (Albany, NY)
- …our caring community and help us put health first** The Grievances & Appeals Representative 3 manages client denials and concerns by conducting a comprehensive ... with clinical and other Humana parties. The Grievances & Appeals Representative 3 performs advanced administrative/operational/customer support duties that require… more
- Catholic Health (Buffalo, NY)
- …role of management and oversight of team Summary: The Clinical Denials and Appeals , Clinical Supervisor is responsible for the people, carrying out and documenting ... the appeals process for denied claims denied due to reasons...Coder (CPC/CCS), Certified Processional Medical Auditor (CPMA), Certified Case Manager (CCM) or any other certification approved by management… more
- Helio Health Inc. (Syracuse, NY)
- …when a question or concern arises. + Communicates insurance trends and unresolved appeals to the billing manager for further action. + Demonstrates adaptability ... files necessary for research and documentation. + Researches open claims and processes appeals when necessary. Follows up on patient and insurance company issues in… more
- CUNY (Brooklyn, NY)
- Manager of Student Advocacy and Accountability (HEA) **POSITION DETAILS** New York City College of Technology of the City University of New York (CUNY), a ... Brooklyn offering associate and baccalaureate degrees, invites applications for a Manager of Student Advocacy and Accountability. Reporting to the Vice President… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **RN/Case Manager MSH Case Management FT Days** The Case Manager (CM) will be responsible for all aspects of case management for an assigned ... or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a minimum...with physicians and managed care companies on concurrent denial appeals e. Communicates clinical information to the payor, as… more
- J&J Family of Companies (New City, NY)
- …and Customer Solutions (PECS) team is recruiting for a Field Reimbursement Manager which will be a field-based position that will include Queens, Brooklyn, ... help overcome challenges to fulfillment, on-boarding, and adherence. The Field Reimbursement Manager (FRM) is responsible for serving as the primary field-based lead… more
- Amgen (New York, NY)
- …us and transform the lives of patients while transforming your career. **Field Reimbursement Manager - New York Metro** **What you will do** Let's do this. Let's ... change the world. In this vital role the Field Reimbursement Manager (FRM) will manage defined accounts within a specified geographic region for Patient Access and… more
- City of New York (New York, NY)
- …hearings by mail, web, and mobile app. In addition, the judges hear appeals of parking ticket determinations, and a special unit for Commercial Adjudications ... conducts hearings and appeals on tickets issued to commercial vehicles. The Customer...Analyst (Non-Managerial Level 2) to serve as the Operations Manager for the STARS Modernization Project. The selected candidate… more
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE CONSTRUCTION PROJECT MANAGER CIVIL SERVICE TITLE, OR BE PERMANENT IN A COMPARABLE TITLE ELIGIBLE FOR 6.1.9 TITLE ... Operations, Bureau of Construction Management is recruiting for one (1) Construction Project Manager II to function as a Senior Construction Project Manager , who… more
- Ralliant (Albany, NY)
- **Job Title:** Product Manager **Location:** Remote, USA **Job Summary:** As a key contributor within Hengstler-Dynapar, the **Product Manager ** will guide the ... aligns with the company's business objectives while collaborating cross-functionally. The Product Manager will work closely with all functions within our company to… more
- Elevance Health (New Hyde Park, NY)
- ** Manager , Medical Director - Transformation Initiatives** Location: This role requires associates to be in-office 3 days per week, fostering collaboration and ... required by law. Alternate locations may be considered. The ** Manager , Medical Director** will serve as a clinical and...the United States when conducting utilization review or an appeals consideration and cannot be located on a US… more
- The Nightingale-Bamford School (New York, NY)
- ANNUAL GIVING MANAGER The Nightingale-Bamford School is seeking candidates for the position of annual giving manager to join the school's advancement team. The ... Fund. Reporting to the assistant director of institutional advancement, the annual giving manager will advance the continued growth of the Nightingale Fund, with a… more