- 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
- Molina Healthcare (Rochester, NY)
- …activities surrounding material updates including provider manuals, letters, and other correspondence related to Medicare Contracted Provider Appeals and ... the activities of the Medicare Contracted Provider Post-Pay Claim Appeals and Disputes in accordance with the standards and... and grievance processing/resolution, including 2 years in a manager role. * Experience reviewing all types of medical… more
- Mount Sinai Health System (New York, NY)
- …as per department protocol (IPRO Discharge Appeals / Insurance requests) + Support Appeals Nurse / Manager by confirming status of denials + Tracking status ... of the Case Management Department by monitoring all incoming correspondence and ensuring it reaches the responsible individuals. Must...+ Requests or provides Medical Records as required for appeals , On / Off-site Insurance reviews + Implements… more
- 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
- Arnot Health (Elmira, NY)
- …3rd party payers 3. Reviews denials from third party payers obtained from correspondence and or payments. Assists in tracking/trending by payer for denial reason ... errors, types and recurring issues. 4. Facilitates, coordinates and prepares denial appeals working with internal and external customers in a proactive manner to… more
- 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
- University of Rochester (Rochester, NY)
- …provider preferences and protocols in selecting for routine and non-routine letters of correspondence related to appeals on denied claims, billing and patient ... GENERAL SUMMARY Under the direct supervision of the Practice Manager , Clinic Director and Nurse Manager works...the Practice Manager , Clinic Director and Nurse Manager works with considerable latitude for independent judgement. Responsible… more
- University of Rochester (Rochester, NY)
- …closure and obtain maximum revenue collection. Researches, corrects, resubmits claims, submits appeals and takes timely and routine action to resolve unpaid claims. ... collection. Key Functions and Expected Performances With general direction of the Manager and with latitude for initiative and judgment: 40% Utilizes A/R experience… more
- The Institute for Family Health (New Paltz, NY)
- …existing policies and procedures for the assigned area. + Reviews and processes correspondence on a daily basis. + Reviews and processes Explanation of Benefits for ... support to senior representatives such as mailing paper claims, preparing spreadsheets for appeals , or maintaining data spreadsheets as directed by the manager … more
- Mount Sinai Health System (New York, NY)
- …with appropriate corrections and documentation. + Works declines and processes appeals . + Ensures that established billing targets for collections, gross, days ... researches and resolves complex claims and corrects errors. + Reviews correspondence and rejection data from insurance carriers; posts rejections and performs… more