- MTA (New York, NY)
- …union representatives to discuss contract grievances and employee discipline appeals ; perform analytical review of claims, grievances, and discipline transcripts; ... prepare substantive letters of decision to Union General Chairman within specified time limitations set forth in collective bargaining agreements. + Provide prompt and accurate responses to labor contract questions or concerns raised by operating department… more
- Molina Healthcare (Nassau, NY)
- …and acute gaps in care and access. Assist members with filing grievances and appeals . * Connects members to CCEs, the OhioRISE Plan,or Molina Care Management if the ... members needs indicate a higher level of coordination. Provide information to members related to Molina requirements , services and benefits . * Knowledge of internal MCO processes and procedures related to Care Guide responsibilities required To all current… more
- Mount Sinai Health System (New York, NY)
- …charge entry. 6. May run and work missing charges, edits, denials list and process appeals . Posts denials in EPIC/IDX on a timely basis. 7. Posts all payments in IDX ... using approved methodologies. 8. May perform specialty coding for services and medical office visits and review physician coding and provide updated to physicians and staff. 9. Works TES, BAR and eCommerce edits for the division, department and physicians.… more
- Sumitomo Pharma (Albany, NY)
- …portfolio, including hub services (benefits investigation, prior authorization, and appeals support), field reimbursement managers, Patient Assistance Program (PAP) ... and copay assistance programs + Drive **data-driven decision-making** , leveraging patient insights and real-world evidence to refine program effectiveness, + **Vendor Oversight** + Oversee **third-party service providers** , ensuring high-quality execution… more
- Evolent (Albany, NY)
- …subject matter expert. + Provides clinical rationale for standard and expedited appeals . + Discusses determinations (peer to peer phone calls) with requesting ... physicians or ordering providers, when available, within the regulatory timeframe of the request. + Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process to reflect appropriate utilization and compliance with… more
- New York State Civil Service (Queens Village, NY)
- …assist in contacting insurance company for preauthorization payments, and/or file appeals on denials of preauthorization. * Participating in the formulation, ... management, development, and oversight of services.* Providing full range of clinical and administrative supervision to subordinate staff; may act as shift supervisor.* Participating in clinical leadership and in committees or work groups as assigned.*… more
- Nexstar Media Group (New York, NY)
- …audiences across all digital devices . Writes, produces and edits material that appeals to target audiences . Research production topics using the internet, video ... archives, and other information sources . Perform other tasks as assigned by news management. Requirements & Skills: . Five or more years' experience in national or major-market news . BA/BS degree or equivalent degree in journalism or related field. . Strong… more
- City of New York (New York, NY)
- …contractual grievance process. Serve as Hearing Officer for grievances and disciplinary appeals . Represent the agency at hearings before the Office of Labor ... Relations and arbitration sessions at the Office of Collective Bargaining. Coordinate the provision of management-side witnesses and any documentation required to support management's position in these proceedings. Negotiate settlements in connection with… more
- City of New York (New York, NY)
- …the New York City Law Department on class action and other major litigation and appeals , and provides legal counsel to program areas on the impact of complex laws ... and regulations on the administration of benefits and services to low-income New Yorkers and vulnerable populations. The Clerical Associate III will provide administrative, clerical, and limited litigation support to the Litigation and Program Counseling Unit.… more
- City of New York (New York, NY)
- …involved in the resolution of matters relating to public assistance client appeals , ensuring that Agency's requirements are met for opening, reopening, denial, ... closing, change in case status and change in benefit entitlements to prevent loss of public funds; ensure compliance with mandated signage being properly posted. - Manage all aspects of the application and recertification processes for public assistance to… more