- Catholic Health Services (Melville, NY)
- …Health was named Long Island's Top Workplace! Job Details The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and appeals ... and/or escalates denial when appropriate. Submits all (initial and/or appeals ) reviews and/or letters within contractual or regulatory timeframes. Collaborates… more
- 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
- 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 ... + Requests or provides Medical Records as required for appeals , On / Off-site Insurance reviews + Implements.../ Off-site Insurance reviews + Implements first step of appeals process to assist Appeals Nurse and… more
- Molina Healthcare (Albany, NY)
- **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical decisions for appeals outcomes within compliance ... standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases in which a formal appeals… more
- CUNY (Brooklyn, NY)
- Manager of Student Advocacy and Accountability (HEA) **POSITION DETAILS** New York City College of Technology of the City University of New York (CUNY), a ... Brooklyn offering associate and baccalaureate degrees, invites applications for a Manager of Student Advocacy and Accountability. Reporting to the Vice President… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **RN/Case Manager MSH Case Management FT Days** The Case Manager (CM) will be responsible for all aspects of case management for an assigned ... care or utilization review preferred. Discharge Planner or Case Manager preferred. Manager or a minimum of...with physicians and managed care companies on concurrent denial appeals e. Communicates clinical information to the payor, as… more
- Mount Sinai Health System (New York, NY)
- **Job Description** RN/Case Manager Mount Sinai West FT Days 8a-4p EOW The Case Manager (CM) will be responsible for all aspects of case management for an ... or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a minimum...with physicians and managed care companies on concurrent denial appeals 5. Communicates clinical information to the payor, as… more
- Hudson Valley Community College (Troy, NY)
- …to build on decades of successful service to our community. Advancement Operations Manager HV-NTP-8575 2 In order to be considered an applicant for this position ... completion of a background check. Position Summary The Advancement Operations Manager position focuses on optimizing donor database (Raiser's Edge) management in… more
- J&J Family of Companies (New York, NY)
- …New York, New York, United States **Job Description:** **Field Reimbursement Manager (Immunology Dermatology)- (** **Manhattan South, NY** **) - Johnson & ... Engagement and Customer Solutions (PECS) team is recruiting for a Field Reimbursement Manager which will be a field-based position that will include the New York,… more
- J&J Family of Companies (Smithtown, NY)
- …Engagement and Customer Solutions (PECS) team is recruiting for a Field Reimbursement Manager which will be a field-based position that will include the Bay Shore, ... help overcome challenges to fulfillment, on-boarding, and adherence. The Field Reimbursement Manager (FRM) is responsible for serving as the primary field-based lead… more