- BronxCare Health System (Bronx, NY)
- …the analysis and preparation of responses to payor denials and develop strong appeals for the purpose of securing reimbursement for acute care services provided to ... identification of patterns and trends identified during the course of appeals preparation. Conduct departmental performance improvement audits, analyze findings and… more
- Catholic Health Services (Melville, NY)
- …services and coordinates utilization/ appeals management review. + Assist Utilization and Appeals Manager in setting up communications with payors and/ or ... facility departments. + Develops/validates daily work lists for Utilization and Appeals Manager . + Assist with all insurance and regulatory audits and provides… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **RN/Case Manager (Inpatient) Mount Sinai Morningside FT Days EOW** The Case Manager (CM) will be responsible for all aspects of case ... or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a minimum...with physicians and managed care companies on concurrent denial appeals 15. Communicates clinical information to the payor, as… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **RN/Case Manager MSH Case Management FT Days** The Case Manager (CM) will be responsible for all aspects of case management for an assigned ... care or utilization review preferred. Discharge Planner or Case Manager preferred. Manager or a minimum of...with physicians and managed care companies on concurrent denial appeals e. Communicates clinical information to the payor, as… more
- J&J Family of Companies (New York, NY)
- …Engagement and Customer Solutions (PECS) team is recruiting for a Field Reimbursement Manager which will be a field-based position that will include the Brooklyn, ... help overcome challenges to fulfillment, on-boarding, and adherence. The Field Reimbursement Manager (FRM) is responsible for serving as the primary field-based lead… more
- City of New York (New York, NY)
- …- Investigates and advises the agency concerning contract disputes, and appeals on the rejection of equipment, materials, or workmanship; compiles contract ... or encapsulation of lead contained in or on any surface. CONSTRUCTION PROJECT MANAGER - 34202 Qualifications 1. A four-year high school diploma or its educational… more
- CUNY (Bronx, NY)
- Associate Director of Compliance and Operations (Financial Aid Manager ) **POSITION DETAILS** The City University of New York (CUNY), the nation's largest public ... aspects of financial aid, from application and award to disbursements, appeals (including special circumstances, professional judgments). + Develops and implements a… more
- NBC Universal (Stamford, CT)
- …to be completed during 2025. Role Summary: Versant Sports is hiring a Sr. Manager , Video Production who will lead our growing team of digital video producer/editors ... platforms, with focus on strategic decisions about how our content best appeals to fans across distribution points. + Cut multiple sports news highlights,… more
- Citigroup (Rockville Centre, NY)
- …to facilitate loan closings, including pipeline management, loan escalations / appeals and advocacy, application quality and pricing issues. + Strictly adhere ... to internal control policies such as the account opening and credit protocols of accurate collection, completion and updating of all required documentation. + Appropriately assess risk when business decisions are made, demonstrating particular consideration… more
- Memorial Sloan-Kettering Cancer Center (New York, NY)
- …+ Work with insurance carriers and MSKCC billing departments to initiate appeals and acquire authorizations for treatment **Key Qualifications:** + Current NYS ... Registered Nurse License/Registration and BSN preferred + At least 2-3 years of clinical hospital nursing experience + Managed care/UR/CM experience strongly preferred + Knowledge of state and federal regulations that govern health insurance coverage +… more
- Northwell Health (Lake Success, NY)
- …Business Office (CBO) operations. + Proficient in denial management and claims appeals . + Comprehensive understanding of diverse insurance payers and policies. + ... Experience supporting multiple service lines. + Strong organizational awareness and cross-functional collaboration. + Adept at identifying and analyzing payer trends. + Skilled in invoice review and financial transaction lifecycle tracking. Job Qualification +… more
- Mount Sinai Health System (New York, NY)
- …Specialist works directly with the Department Administrator. Reports to Billing Manager /Revenue Cycle Manager . **Qualifications** + Associates Degree preferred + ... financial implications of out-of-network benefits, including pre-determination of benefits, appeals and/or pre-certification limitations. + Develop and manages fee… more
- City of New York (New York, NY)
- …PERMANENT EMPLOYEES IN THE TITLE AND THOSE THAT ARE REACHABLE ON THE ADMINISTRATIVE MANAGER CIVIL SERVICE LIST ARE ELIGIBLE TO APPLY. The New York City Department of ... work. Job Duties and Responsibilities: - Serve as the Reasonable Accommodations Appeals Unit coordinator and processing incoming requests. - Maintain an agencywide… more
- Research Foundation CUNY (New York, NY)
- …the rating team; monitor ratings for consistency and accuracy, review appeals , implement inter-rater reliability systems, and monitor the Standards Inventory ... for consistency. Reporting to the Data Systems and Ratings Manager , the Ratings Specialist will lead the management of...+ Support the work of Data Systems and Ratings Manager to maintain ongoing monitoring systems for the QUALITYstarsNY… more
- Mount Sinai Health System (New York, NY)
- …charge entry. 6. May run and work missing charges, edits, denials list and process appeals . Posts denials in EPIC/IDX on a timely basis. 7. Posts all payments in IDX ... billing concerns. 16. Mentors less experienced Billing staff and assists Billing Manager /FPA Manager in training new staff. 17. May approve EPIC work queue for… more
- Elevance Health (New Hyde Park, NY)
- …a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military base, vessel or any ... in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance Health location at least… more
- Catholic Health Services (Melville, NY)
- …Job Details Under the direction of the Physician Revenue Realization Manager , the Insurance Follow-Up Representative is responsible for investigating claims status ... with established standards and procedures. + Determines reason for denial and appeals accounts as necessary. + Reviews and edits any rejections stemming from… more
- The Estee Lauder Companies (Melville, NY)
- …pertains to state income tax planning). This position supervises and manages a Tax Manager and a Temporary Labor force comprised of 4 persons assisting with all ... Tax negotiations and audit settlements. Assist with the preparation of tax appeals and protests. * Identify Sales Tax Planning Opportunities, quantifying the savings… more
- Elevance Health (New York, NY)
- …for services requested. + Makes medical necessity determinations for grievance and appeals appropriate for their specialty. + Ensures consistent use of company ... in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance Health location at least… more
- Elevance Health (New York, NY)
- …for services requested. + Makes medical necessity determinations for grievance and appeals appropriate for their specialty. + Ensures consistent use of medical ... in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance Health location at least… more