- 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
- City of New York (New York, NY)
- …- Assisting in processing, evaluating and preparing responses to appeals from people in custody concerning the Minimum Standards EXPERIENCE/QUALITIES/SKILLS ... STRONGLY PREFERRED - Collegial approach to teamwork across disciplines - Master's degree in a social science discipline, public policy or related field - At least three years of government, nonprofit, or comparable experience - Experience at a regulatory… more
- City of New York (New York, NY)
- …as relevant issues arise. - Ensure timely and accurate responses to requests and appeals under the Freedom of Information Law (FOIL). - Serve as the Privacy Officer ... for the Agency and act as a liaison with Counsel and Chief Privacy Officers across various City agencies. - Conduct legal research and draft legal opinions, memoranda, and policy statements as necessary. - Plan or consult on new strategic initiatives that… more
- MTA (Jamaica, NY)
- …or modify decisions made by Department Heads/designees related to such appeals . Represent the LIRR at contract interpretation and disciplinary arbitrations. Prepare ... persuasive and well supported briefs/submissions for arbitration. Present Carrier's position through oral argument in arbitration hearings. + Manage and provide direction to departmental managers in handling contract interpretation, employee complaints,… more
- WMCHealth (Suffern, NY)
- …to ensure patient has coverage, services provided are covered, denials and appeals minimized and payments are expedited. + Reviews registration data for accuracy ... and satisfying delinquent data for a quality assurance. + Handles the printing and distribution of Admission/Registration forms, face sheets, labels and NY State and Federally mandated forms to patients or nursing unit as appropriate. + Obtains witnessing… more
- Evolent (Albany, NY)
- …(NCQA) guidelines. + Provides clinical rationale for standard and expedited appeals . + Ensures documentation of all communications with medical office staff ... and/or MD provider is recorded in a timely and accurate manner. + Participates in on-going training per inter-rater reliability process. + On a requested basis, may function as Medical Director for selecting health plans or regions, assuming overall… more
- Adelphi University (Garden City, NY)
- …subsequent ISIR records and repackage awards when necessary. + Review appeals and exercise professional judgement following federal and institutional policies. + ... Effectively and independently manage and administer one of a group of special programs and/or specific student populations that require specific in-depth knowledge and understanding + Manage high volume processing as assigned + Utilize financial aid platforms… more
- Brighton Health Plan Solutions, LLC (Melville, NY)
- …healthcare providers with member benefits, eligibility, claims inquiry, claim reconsiderations and appeals . This job description is not designed to cover or contain ... a comprehensive listing of activities, duties or responsibilities, and activities may change, or new ones may be assigned at any time with or without notice. Primary Responsibilities * Listen attentively to customer needs and concerns; demonstrate empathy and… more
- Calvary Hospital (Bronx, NY)
- …to facilitate reimbursement for services provided by the Hospital. Oversees the appeals process for those cases for which reimbursement has been denied. Conducts ... interdepartmental meetings related to the quality and utilization of clinical services. Serves on various Hospital committees as assigned. Attends meetings and seminars as appropriate. Ensures all related manuals are kept current. Works within legal, ethical… more
- Rochester Regional Health (Rochester, NY)
- …coverage policies and/or phone calls to the payer. Submit corrected claims and appeals . + Process account adjustments and refunds as needed according to department ... policy and procedure. + Document actions appropriately and follow-up with payers to ensure they take actions promised. Follow-up on claims with no responses. Manage large workload using tracking tools to ensure we don't fail to follow-up before a payer's… more