- 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 ... policies when making medical necessity decisions. + Brings to their supervisors attention, any case review decisions that require + Medical Director review or policy interpretation. **Minimum Requirements:** + Requires MD or DO and Board certification approved… more
- Northwell Health (Lake Success, NY)
- …+ Coordinates clinical documentation requests to business office to ensure timely appeals . + Develops and implements policies and procedures to facilitate billing ... and maximize case collections. + Reviews and recommends 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… more
- The Institute for Family Health (New Paltz, NY)
- …to senior representatives such as mailing paper claims, preparing spreadsheets for appeals , or maintaining data spreadsheets as directed by the manager (s). + ... Communicates to management information related to changes required for designated areas to facilitate the collection of accounts receivable. + May be responsible for specific Aged Accounts Receivable's on a weekly basis to ensure that designated accounts are… more
- Shinda Management Corporation (Queens Village, NY)
- …and applications, including remarketing assessments, interviewing applicants, and processing appeals + Process tenant rental payments, Housing Assistance Payments ... (HAP), post HAP Payments, manage Tenant Rental Assistance Certification System (TRACS) and review Tenant Income Certification (TICs). Some sites required processing and reviewing EIV reports/corrections, repayment agreements, and process special claims +… more
- City of New York (New York, NY)
- …States law school as defined in the Rules of the New York Court of Appeals (Sections 520.3 or 520.5) or admission to the New York State Bar. Additional Information ... The City of New York is an inclusive equal opportunity employer committed to recruiting and retaining a diverse workforce and providing a work environment that is free from discrimination and harassment based upon any legally protected status or protected… more
- Cardinal Health (Albany, NY)
- …* Follow through on all benefit investigation rejections, including Prior Authorizations, Appeals , etc. All avenues to obtain coverage for the product must be ... fully exhausted * Track any payer/plan issues and report any changes, updates, or trends to management * Search insurance options and explain various programs to the patient while helping them to select the best coverage option for their situation * Handle all… more
- New York State Civil Service (Rensselaer, NY)
- …in defending the Office in various types of proceedings: Article 78 appeals involving challenges to administrative hearing decisions, Section 1983 Federal Civil ... Rights litigation, and NYS Court of Claims matters.Additional duties will be discussed in detail during the interview. Minimum Qualifications Transfer: One year of permanent competitive or 55b/c service in this title or in a title eligible for 70.1 or 52.6… more
- Cardinal Health (Albany, NY)
- …insurance plan coverage, including out-of-pocket costs, and provide guidance on the appeals process if needed + Resolve patient's questions and any representative ... for the patient's concerns regarding status of their request for assistance + Demonstrate expertise in payer landscapes and insurance processes. Remain knowledgeable about long and short-range changes in the reimbursement environment including Medicare,… more
- Sumitomo Pharma (Albany, NY)
- …to support business objectives. + Manage caseload of patent litigations, appeals , and other adversarial proceedings, while advising on substantive legal strategy ... with foresight and appropriate risk tolerance. + Work with internal teams to manage legal holds and oversee the gathering and preservation of documents and other information for discovery. + Assist in identifying and preparing internal employees who may serve… more
- Touro University (New York, NY)
- …with graduate and professional school admissions procedures. + Prepare and submit appeals to the Committee on Academic Standing. + Compile lists of potential ... graduates each semester. + Work with potential students to inform them about the college and help them decide if Touro is the appropriate college for them and which Touro program can best serve their needs. + Student Support and Advocacy: + Assist in the… more