- BronxCare Health System (Bronx, NY)
- Overview The Appeals Manager is responsible to assist in the analysis and preparation of response to denial notification letters that arrive in letter and ... to best respond to all hospital denials notification and documentation efforts. The Appeals Manager will provide timely tracking and trending of all denials and … 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
- Molina Healthcare (Rochester, NY)
- …Manages team responsible for the submission/resolution of member and provider appeals and grievances; ensures resolutions are compliant with applicable standards and ... call tracking system of correspondence and outcomes for provider and member appeals /grievances; oversees/monitors appeals to ensure all internal and regulatory… 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)
- **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse (RN) provides support for internal appeals clinical processes - ensuring that appeals requests ... strategy to provide quality and cost-effective member care. Candidates with UM and Appeals experience are highly preferred Work hours: Monday- Friday 8:00am - 5:00pm… 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
- 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 ... care or utilization review preferred. Discharge Planner or Case Manager preferred. Manager or a minimum of...with physicians and managed care companies on concurrent denial appeals e. Communicates clinical information to the payor, as… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **RN/Case Manager (Inpatient) Mount Sinai Morningside FT Days EOW** The Case Manager (CM) will be responsible for all aspects of case ... or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a minimum...with physicians and managed care companies on concurrent denial appeals 15. Communicates clinical information to the payor, as… more
- MVP Health Care (Rochester, NY)
- …thinking and continuous improvement. To achieve this, we're looking for a **Case Manager , Medicaid Long Term Support Program** to join #TeamMVP. If you have a ... complex Medicaid members. + Through collaborative efforts the Case Manager will identify the medical and psycho-social needs of...maintain cost-effectiveness and manage Medical Loss Ratio (MLR). + Appeals & Denials: Participate in the appeals … more
- Catholic Health (Buffalo, NY)
- …Overtime: Exempt: Yes Work Schedule: Days Hours: 8a-4p Summary: The Manager Government Reimbursement reports to the Director Government Reimbursement and Managed ... Care. The Manager is responsible for the coordination, preparation, and timely...Champus cost reports, surveys, rate reviews, filing of rate appeals , determination of state and federal budget impacts on… more
- City of New York (New York, NY)
- …- Investigates and advises the agency concerning contract disputes, and appeals on the rejection of equipment, materials, or workmanship; compiles contract ... or encapsulation of lead contained in or on any surface. CONSTRUCTION PROJECT MANAGER - 34202 Qualifications 1. A four-year high school diploma or its educational… more
- SUNY Geneseo (Geneseo, NY)
- College Advancement Communications Manager Bookmark this Posting Print Preview | Apply for this Job Please see Special Instructions for more details. Please attach a ... Vacancy Announcement Position Information Campus Title College Advancement Communications Manager Department College Advancement Position Summary Join SUNY Geneseo… 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
- Merck (Albany, NY)
- **Job Description** Field Access Manager The Field Access Manager (FAM) serves as the subject-matter expert on access related issues for healthcare professionals ... HCP accounts on patient access, including benefit verification, prior authorization process, appeals process, and patient support programs in both live and virtual… more
- CUNY (Bronx, NY)
- Associate Director of Compliance and Operations (Financial Aid Manager ) **POSITION DETAILS** The City University of New York (CUNY), the nation's largest public ... aspects of financial aid, from application and award to disbursements, appeals (including special circumstances, professional judgments). + Develops and implements a… more
- Guardian Life (Albany, NY)
- …to Dental Support Organization (DSO) partners. As a **Key DSO Dental Account Manager , Dental Support Organizations** , you will be responsible for growing the ... for all assigned DSOs. Respond to provider inquiries, concerns, complaints, appeals and grievances within assigned timeframes. Collaborate across teams to resolve… more
- Merck (Albany, NY)
- …of patient enrollment process, payer coverage policies, prior authorization process, appeals process, patient support programs, and Hub operations to Field Access ... Management team. * Participate in cross-functional meetings with sales, market access, and marketing to ensure alignment and understanding of the access landscape, issues, and field access strategy. **Minimum Requirements:** * Bachelor's Degree; 9+ years in… more
- Citigroup (Smithtown, NY)
- …to facilitate loan closings, including pipeline management, loan escalations / appeals and advocacy, application quality and pricing issues. + Strictly adhere ... to internal control policies such as the account opening and credit protocols of accurate collection, completion and updating of all required documentation. + Appropriately assess risk when business decisions are made, demonstrating particular consideration… more
- Mount Sinai Health System (New York, NY)
- …collection. The Specialist works directly with the Department Administrator. Reports to Billing Manager /Revenue Cycle Manager . *Please note that this is NOT a ... financial implications of out-of-network benefits, including pre-determination of benefits, appeals and/or pre-certification limitations. + Develop and manages fee… more
- WMCHealth (Valhalla, NY)
- …Job Details: Job Summary: The Senior Inpatient Coder is responsible for addressing appeals to insurance companies and coding highly complex medical records using the ... role is expected. Does related work as required. Responsibilities: + Addresses appeals to insurance denials to facilitate expedient resolution and reimbursement. +… more