- 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
- 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)
- …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
- Hackensack Meridian Health (Hackensack, NJ)
- …Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of clinical records ... not limited to utilization review, hospital reimbursement, clinical compliance, case management , and transitions of care, as outlined in the responsibilities below.… more
- Molina Healthcare (Yonkers, 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