- New York State Civil Service (Albany, NY)
- …for the Department in administrative hearings at the Division of Tax Appeals and/or in other court matters. Representation includes full case preparation; pleadings; ... argument of tax cases. It may also include assisting the AG's Office in appeals and other court matters, depending on the nature of the case. Minimum Qualifications… more
- CVS Health (Albany, NY)
- …of claim related participation and pricing issues. + Reading and interpreting appeals , standard reference materials, etc. **Required Qualifications** + 2+ years of ... healthcare experience in a managed care environment. + 2+ years experience working with medical terminology, claim forms, and physician billing coding. + 1+ years of experience with provider disputes. + Computer proficiency with Microsoft Office Applications.… more
- Evolent (Albany, NY)
- …of the request and provides clinical rationale for standard and expedited appeals . + Utilizes medical/clinical review guidelines and parameters to assure consistency ... in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines. + Aids and acts as a… more
- Rochester Regional Health (Rochester, NY)
- …the medical management department in the tracking, trending and reporting of appeals and charge recovery information. + Conducts reviews of cost outliers and ... collaborates with other hospital operating areas to recover billed charges. Tracks reporting activities and prepares reports for management presentation. + Provides ongoing support for the tracking and trending of the Reimbursement Specialist charge recovery… more
- Northwell Health (Staten Island, NY)
- …Carries out clinical documentation requests to business office to ensure timely appeals . + Implements policies and procedures to facilitate billing and maximize case ... collections. + Implements improvements for financial management of each billing area. + Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not… more
- UIC Government Services and the Bowhead Family of Companies (New York, NY)
- …Courts, representing DHS in appellate proceedings before the Board of Immigration Appeals , and providing support and direction to the Department of Justice, Office ... of Immigration Litigation, as well as to the US Attorney's Offices nationwide. The Chief Counsel's office handles confidential and high-level documentation. This position is full-time, benefits eligible at an hourly rate of $22.72 plus $4.93 H&W (Health and… more
- University of Rochester (Brighton, NY)
- …edits, and obtains signatures for non-routine letters of correspondence related to appeals on denied claims, including compiling all necessary information and drafts ... for provider signature. + Manages provider(s) documentation and information. + Composes and types of non-routine correspondence providing factual information. + Arranges travel, conference registration, and hotel accommodations. Interfaces with organizations,… more
- Health Advocates Network (Albany, NY)
- …skills. **Perform related duties as required:** * Screen requests for External Appeals in accordance with the Federal No Surprise Act. * Screen requests ... for External Appeal in accordance with Insurance Law, Regulation, and the established protocols. * Act as liaison using written and verbal communication for administrative processes with consumers and representatives of financial entities. * Keep electronic… more
- City of New York (New York, NY)
- …sentencing information/outcome. - Complete order to produce forms, surety forms, waiver of appeals , order of protections and other legal documents to be filed in ... criminal, supreme and the arraignment court parts. - Assist standing ADAs with issues that may arise in in criminal, supreme and the arraignment court parts. - Assist with inquiries from defense attorneys, arresting officers and court staff as directed. -… more
- City of New York (New York, NY)
- …audit responses, site standard adherence for financed construction work, public-facing appeals and hearings, and managing risk for the agency. The Executive ... Director of Compliance will use their expertise to provide leadership and technical assistance for CRM and compliance functions throughout the agency. They will ensure the agency is meeting Federal, State, and City obligations; promote the seamless integration… more