- 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
- Nuvance Health (Danbury, CT)
- …delays in reimbursement. This role plays a critical part in preventing payment denials by providing timely and accurate clinical information to all payers, ... initial status is to be re-considered. * Identify incomplete clinical reviews in work queues and complete them within...notice of conversion, etc. * Tracking and trending all appeals and communicating on a daily/regular basis with the… more
- Nuvance Health (Danbury, CT)
- …Hours 5-9pm- Rotate Weekends/Evenings* *Summary:* Provides high quality administrative support to Clinical Denial Prevention & Appeals Specialist RNs, ... and facilitates communications with the System Business Office related to appeals , denial and clinical reviews 9. Reviews new denials and appeal upheld… more
- 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 (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
- 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