- Molina Healthcare (Buffalo, NY)
- …systems and other available resources. + Assures timeliness and appropriateness of appeals according to state and federal and Molina Healthcare guidelines. + ... Determines appropriate language for letters and prepare responses to appeals and grievances. + Elevates appropriate appeals ...to appeals and grievances. + Elevates appropriate appeals to the Appeals Specialist. + Generates… more
- Northwell Health (Melville, NY)
- …current state, federal, and third-party payer regulations. Ensures clinical reviews and appeals are up to date and accurately reflect patient's severity of illness ... Skills 3-5 years experience in Utilization Review, Case Management, and Clinical Appeals . 3-5 years of acute inpatient clinical experience. Experience with MCG… more
- City of New York (New York, NY)
- …experienced attorney (3+ years) to handle post-conviction litigation, including direct appeals , motion responses, and federal writs of habeas corpus. JOB ... effectively in oral and written format Brief and argue a substantial caseload of appeals before the state and federal courts All other duties as assigned ASSISTANT… more
- City of New York (New York, NY)
- …Attorney is seeking an Attorney Assistants (TPA 2) to assist Appeals Bureau Assistant District Attorneys with post-conviction matters. JOB RESPONSIBILITIES: Specific ... duties will include, but are not limited to, the following: - Proofreading and cite checking legal documents - Drafting Tables of Contents and Tables of Authorities - Formatting and preparing documents for filing in compliance with court rules - Maintaining a… more
- Humana (Albany, NY)
- …Medical Director relies on medical background and reviews health claims and preservice appeals . The Corporate Medical Director works on problems of diverse scope and ... complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with review policies, procedures, and… more
- Humana (Albany, NY)
- …Director (CMD) relies on medical background to review health claims and preservice appeals . The Corporate Medical Director works on problems of diverse scope and ... complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions regarding the appropriateness and medical necessity of services provided by other healthcare professionals in compliance with coverage… more
- City of New York (New York, NY)
- …and Article 78 requests and simultaneously handle post-conviction litigation, including direct appeals , Article 440 motions, and federal writs of habeas corpus. JOB ... made through Office internal request system Make recommendations to Appeals Bureau Chief on viability of such appeals... Appeals Bureau Chief on viability of such appeals and communicate with other bureaus about requests Draft… more
- New York State Civil Service (Albany, NY)
- NY HELP Yes Agency Tax Appeals , Division of Title Counsel Occupational Category Legal Salary Grade NS Bargaining Unit M/C - Managerial/Confidential (Unrepresented) ... Code 12223 Duties Description The Counsel to the Tax Appeals Tribunal (Counsel) serves as the chief legal advisor...serves as the chief legal advisor to the Tax Appeals Tribunal (Tribunal) and chief legal officer for the… more
- Mount Sinai Health System (New York, NY)
- …the department as per protocol + Requests or provides Medical Records as required for appeals , On / Off-site Insurance reviews + Implements first step of appeals ... in Allscripts + Meets time frame for reviews / appeals as specified by Insurance / State & Federal...Photo Copying Service, outside 2nd party and / Discharge Appeals + Maintain the integrity of the Medical Record.… more
- MTA (Brooklyn, NY)
- …needed basis , 1 to 3 days per week serving on the Paratransit Eligibility Appeals Board. The physician will provide medical expertise and support in the review of ... appellants' application and eligibility determination documentation. + Assist the Eligibility Appeals Director with conducting eligibility appeals via telephone,… more