- BronxCare Health System (Bronx, NY)
- Overview The Appeals Manager is responsible to assist in the analysis and preparation of response to denial notification letters that arrive in letter and ... to best respond to all hospital denials notification and documentation efforts. The Appeals Manager will provide timely tracking and trending of all denials and … more
- Mount Sinai Health System (New York, NY)
- …issues in an accurate and timely fashion. In collaboration with the Underpayment Team manager , the Senior CBO Appeals Analyst will work to further the CBO's ... **Job Description** The Senior CBO Appeals Analyst position requires an in-depth knowledge of...hospital/healthcare environment is required. Advanced knowledge of Epic, Contract Manager , and Microsoft Excel Working knowledge of other Microsoft… more
- Molina Healthcare (Yonkers, NY)
- …for leading, organizing and directing the activities of the Grievance and Appeals Unit that is responsible for reviewing and resolving member complaints and ... * Leads, organizes, and directs the activities of the Appeals & Grievances unit that is responsible for reviewing... and grievance processing/resolution, including 2 years in a manager role. * Experience reviewing all types of medical… more
- Mount Sinai Health System (New York, NY)
- …to Case Managers and other hospital personnel as needed. The Nursing Clinical Manager collaborates with Appeals Management, Managed Care Contracting and other ... **Job Description** The Nursing Clinical Manager (NCM) for Case Management is responsible for...performance evaluation, performance improvement, and staff education. The NCM Manager serves as a resource/mentor for Case Managers, Social… 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 ... or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a minimum...with physicians and managed care companies on concurrent denial appeals e. Communicates clinical information to the payor, as… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **RN/Case Manager Inpatient Mount Sinai West FT Days 8a-4p EOW (Holiday Rotation)** The Case Manager (CM) will be responsible for all aspects ... or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a minimum...with physicians and managed care companies on concurrent denial appeals 5. Communicates clinical information to the payor, as… more
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE CONSTRUCTION PROJECT MANAGER CIVIL SERVICE TITLE, OR BE PERMANENT IN A COMPARABLE TITLE ELIGIBLE FOR 6.1.9 TITLE ... Operations, Bureau of Construction Management is recruiting for one (1) Construction Project Manager II to function as a Senior Construction Project Manager , who… more
- Tutor Perini (New York, NY)
- …now or in the future Frontier-Kemper-Tutor Perini joint venture is seeking a **Safety Manager ** to join our Manhattan Tunnel Project in New York, New York. **About ... facility. **_Extraordinary Projects Need Exceptional Talent_** As a **Safety Manager ** at Frontier-Kemper-Tutor Perini joint venture, reporting to the **Safety… more
- The Nightingale-Bamford School (New York, NY)
- ANNUAL GIVING MANAGER The Nightingale-Bamford School is seeking candidates for the position of annual giving manager to join the school's advancement team. The ... Fund. Reporting to the assistant director of institutional advancement, the annual giving manager will advance the continued growth of the Nightingale Fund, with a… 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
- Mitsubishi Chemical Group (Jersey City, NJ)
- …evidence, and creating hope for all facing illness. The Senior Manager , Incentive Compensation is responsible for planning, developing, and implementing fair ... specific field performance issues related to IC; review and manage adjustments, appeals and impact analyses across systems and reports, offering training and support… more
- City of New York (New York, NY)
- …THE CIVIL SERVICE LIST ARE ELIGIBLE TO APPLY. The Human Capital Manager will oversee labor relations, disciplinary processes, and talent management initiatives ... conducting related training sessions. - Serve as hearing officer for disciplinary appeals , draft decisions, stipulations, and prepare research for Step I, Step II,… more
- City of New York (New York, NY)
- …Division of Emergency Housing Services (EHS). Your Impact: As the Case Manager /Community Coordinator for the Division of Emergency Housing Services, you will assist ... - Document hearing outcomes including program re-instatement, termination and shelter exit, appeals and Article 78 cases. Preferred skills - Minimum 2 years of… more
- City of New York (New York, NY)
- …to treatment and application assistance with the federal disability application and appeals processes as appropriate. Under the general direction of the Director of ... for one (1) Administrative Contract Specialist, NMI to serve as a Contract Development Manager in CAS' Office of Contract, Finance & Management Planning, who will: -… more
- Federal Reserve Bank (Newark, NJ)
- …(CFPB) payroll and HR groups on plan interpretations, participant inquiries and appeals and payroll matters impacting the benefits plans. Accountable for the ... day-to-day operations and administration of one or more of the System's retirement and executive benefits plans. Provide guidance in addressing benefits related issues and interpret applicable plan provisions, legislation, and regulations pertaining to the… 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
- Amazon (Newark, NJ)
- …communications - Serve as the point of escalation for fraud related termination appeals for second tier investigations, and work with Legal partners in handling ... those appeals appropriately - Create and maintain fraud investigations and...operations, work with the Audible Fraud Defense program product manager on creating and implementing the fraud defense roadmap… more
- Molina Healthcare (Yonkers, NY)
- …The Pharmacist, UM will be responsible for reviewing coverage determinations and appeals in a timely, compliant, and accurate manner. The Pharmacist, UM will ... Ensures Molina is compliant with the coverage determination and appeals process. + Contributes to projects aimed at improving...the pharmacy call center team as delegated by the Manager . + Identifies and implements programs to improve clinical… more
- Mount Sinai Health System (New York, NY)
- …and procedures. 3. May run and work missing charges, edits, denials list and process appeals . Posts denials in IDX on a timely basis. 4. Posts all payments in IDX ... billing concerns. 13. Mentors less experienced Billing staff and assists Billing Manager /FPA Manager in training new staff. 14. May approve EPIC work queue for… more
- Elevance Health (Morristown, NJ)
- …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