- CenterLight Health System (NY)
- JOB PURPOSE: The Claim Appeals and Audit Specialist ...by timely and accurate processing of claims appeals and performing claims audit , ... to determine if system or procedural changes could enhance claim workflow and efficiency. + Analyze patient and medical...is strongly preferred. + Experience in claims appeals and/or claims audit within… more
- Molina Healthcare (Yonkers, NY)
- …following: + Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare ... **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct...a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge,… more
- Independent Health (Buffalo, NY)
- …correlating coding complexity. They will aid in training other team members, evaluating appeals , and share audit trends across the team. Expertise and ... knowledge and audit tips across the team. The Clinical & Coding Specialist -Senior will support the leadership in Hospital Audit in accomplishing all aspects… more
- Mohawk Valley Health System (New Hartford, NY)
- Compliance Coding Specialist - Hybrid - Full time - Days Department: LEGAL AND COMPLIANCE Job Summary The Internal Auditor - Compliance will oversee the internal and ... external compliance audits for the Mohawk Valley Health System ("MVHS") audit and compliance function under the guidance and direction of the Chief Compliance… more
- Shinda Management Corporation (Queens Village, NY)
- …required processing and reviewing EIV reports/corrections, repayment agreements, and process special claims + Pre- audit LIHTC/HUD and HOME tenant files for all ... Compliance Specialist About the Organization For over three decades,...and applications, including remarketing assessments, interviewing applicants, and processing appeals + Process tenant rental payments, Housing Assistance Payments… more
- New York State Civil Service (Buffalo, NY)
- NY HELP Yes Agency Insurance Fund, State Title Insurance Fund Services Specialist 2 (HELPS) Occupational Category Financial, Accounting, Auditing Salary Grade 18 ... annually for 15-8 reimbursement requests within 52 weeks of payment benefits.* Complete appeals for denied 15-8 reimbursement and help case managers (CM) to complete… more