- 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
- Trinity Health (Syracuse, NY)
- …insurance updates prior to procedure, and supporting authorization and denial processes. **EDUCATION, TRAINING, EXPERIENCE, CERTIFICATION AND LICENSURE:** Certified ... Coding Specialist , Accredited Record Technician (or eligible), Registered Record Administrator (or eligible) or Licensed Practical Nurse (LPN) with a minimum of 5… more
- Datavant (Albany, NY)
- …experiences to realize our bold vision for healthcare. The purpose of the Denial Prevention Specialist is to effectively defend utilization of available health ... Medical Director as needed to facilitate timely authorizations and/or denial reversals + Maintain and keeps in total confidence,...as it relates to job function as delegated by management Ideal candidate should be a Licensed Practical Nurse… more
- Saratoga Hospital (Saratoga Springs, NY)
- …for tracking denied HIS inpatient accounts, working with HIS Coders, payers, Department Directors, Clinical Managers, Case Management , Patient Access, and PFS ... HIS Denials Specialist (Inpatient) Location: Saratoga Hospital, 211 Church Street,...Springs, NY 12866 Employment Type: Full Time Shift/Schedule: 8a-4p Department : Health Information services Salary Range: $27.78-35.90 / hourly,… 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
- Rochester Regional Health (Rochester, NY)
- …underpaid by third party payers and to resolve the issues resulting in denial /underpayment and to formally appeal. The specialist will conduct comprehensive ... SUMMARY The C & D specialist is responsible for reviewing accounts which have...STATUS: Full Time LOCATION: SLH - Regional Administrative Campus DEPARTMENT : Patient Financial Services SCHEDULE: 8am-4pm Responsibilities Responsibilities will… more
- University of Rochester (Rochester, NY)
- …Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department : 500011 Patient Financial Services Work Shift: UR - Day (United States ... Summary With latitude for initiative and independent judgment within department guidelines, the position is responsible for managing professional...EPIC follow up workqueue(s). + Review reason for claim denial - reason code or denial codes… more
- Molina Healthcare (Buffalo, 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