- 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
- 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
- City of New York (New York, NY)
- …is provided to those who fail to meet requirements. Your Impact: The Risk Management Specialist will identify and address potential risk for fraud. The ... of Housing Access and Stability: The New York City Department of Housing Preservation and Development (HPD) is the...of HPD's Section 8 program rules. Responsibilities: The Risk Management Specialist will be responsible for the… more
- Mount Sinai Health System (New York, NY)
- …Mgmt FT Days EOW** To maintain front end operations of the Case Management Department by monitoring all incoming correspondence and ensuring it reaches ... Is cognizant of the philosophy, standards, objectives and policies of the Department and the Hospital Center. **Qualifications** + Applicable work experience may be… 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
- Nuvance Health (Danbury, CT)
- …/ WEEKEND ROTATIONS REQUIRED* * *Hybrid/Remote* * *Summary:* The purpose of the Denial Prevention Nurse is to ensure that all patient admissions are appropriately ... the lack of a review may result in a denial , escalate to the appropriate Provider/VPMA. * Identify and...and communicating on a daily/regular basis with the Denials Management team. * Assists with informing Managed Care contracting… more
- Nuvance Health (Danbury, CT)
- …Responsible for the assigned areai? 1/2s claims submission, payment application, denial management , and account follow-up to ensure optimal reimbursement. ... 6. Adjusts account balances to specific account needs. 7. Maintains Contract Management reporting (ie, payment errors, carve out billings) and updates any… 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