• Appeals Manager

    BronxCare Health System (Bronx, NY)
    …the analysis and preparation of responses to payor denials and develop strong appeals for the purpose of securing reimbursement for acute care services provided to ... identification of patterns and trends identified during the course of appeals preparation. Conduct departmental performance improvement audits, analyze findings and… more
    BronxCare Health System (09/19/25)
    - Related Jobs
  • Grievance/ Appeals Representative I

    Elevance Health (Latham, NY)
    **Grievance/ Appeals Representative I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... unless an accommodation is granted as required by law._ The **Grievance/ Appeals Representative I** is responsible for reviewing, analyzing and processing member… more
    Elevance Health (12/05/25)
    - Related Jobs
  • Construction Project Manager

    City of New York (New York, NY)
    …and progress. Uses computers to maintain files and generate reports, correspondence , and other paperwork. - Investigates and advises the agency concerning ... contract disputes, and appeals on the rejection of equipment, materials, or workmanship;...community and members of the public. Prepares reports and correspondence for approval in dealings with contractors and the… more
    City of New York (11/07/25)
    - Related Jobs
  • Senior Consumer Frauds Representative or Consumer…

    New York State Civil Service (Albany, NY)
    …for distribution to callers and complainants. * Evaluates all incoming correspondence directed to the Health Care Bureau Helpline, identifies proper jurisdiction, ... and assigns routine correspondence to support staff. * Responds to inquiries, informs...rights, advises them of complaint filing procedures, assist with appeals /grievances, or refers them to other government or private… more
    New York State Civil Service (12/02/25)
    - Related Jobs
  • Medical Services Coordination Specialist I/II/III

    Excellus BlueCross BlueShield (Rochester, NY)
    …as needed. + Prepares and assists in handling member and provider correspondence related to authorization detail, disease conditions and/or care management program ... assigned to non-care managers are monitored by the care manager + The care manager provides feedback...programs + Provides administrative support to the grievance and appeals process within the + Medical Services department Level… more
    Excellus BlueCross BlueShield (10/21/25)
    - Related Jobs
  • Workers' Compensation Examiner (NY Helps), Wcb…

    New York State Civil Service (Schenectady, NY)
    …report cards, performance penalties or appeal procedures. Prepare written correspondence correctly. * Responsible for the distribution of quarterly performance ... Board to make a ruling. Recognize communications that are appeals of penalties and insure they are responded to...hybrid telecommuting schedule can be discussed with the hiring manager during the interview.We offer a work-life balance and… more
    New York State Civil Service (12/04/25)
    - Related Jobs
  • Clm Resltion Rep III, Hosp/Prv

    University of Rochester (Albany, NY)
    …Receivable Management. **ESSENTIAL FUNCTIONS** With general direction of the Manager /Supervisor/Lead: 40% Follows department policies and procedures and maintains ... up on multi-faceted denials through review of remittances (EOBs), insurance correspondence , rejections received thru daily electronic and claims submission, etc. +… more
    University of Rochester (11/27/25)
    - Related Jobs
  • Administrative Support Associate VI - Hospital…

    Albany Medical Center (Albany, NY)
    …for services provided by hospital of Albany Med Health System by competing appeals , phone calls, and account review. Qualifications: High school diploma or GED is ... resolve underpayments, overpayments, rejections & denials.Reviewing and replying to correspondence relating to the outstanding receivables and identifying and/or… more
    Albany Medical Center (11/12/25)
    - Related Jobs
  • Bilingual Immigration Coordinator - Spanish…

    HANAC, Inc. (Astoria, NY)
    …part of a team with the immigration attorney, Board of Immigration Appeals (BIA) accredited representative, and support staff. The Immigration Paralegal will assist ... + Identify the process to alleviate client issues + Work with a case manager to complete required immigration paperwork + Consult with staff attorney to overcome… more
    HANAC, Inc. (11/07/25)
    - Related Jobs
  • Clm Resltion Rep II, Hosp/Prv

    University of Rochester (Rochester, NY)
    …include but are not limited to researching, correcting, resubmitting claims, submitting appeals and taking timely and routine action to resolve unpaid claims. The ... Receivable Management. **ESSENTIAL FUNCTIONS** **_With general direction of the Manager /Supervisor/Lead:_** 40% + Follows department policies and procedures and… more
    University of Rochester (09/24/25)
    - Related Jobs