• Clinical Denials & Appeals

    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
    Northwell Health (10/11/25)
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  • Insurance Specialist -Mount Sinai…

    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 (07/23/25)
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  • Utilization Management Specialist -MSH-Case…

    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
    Mount Sinai Health System (10/03/25)
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