- Lincoln Financial (Albany, NY)
- …for this opportunity. **Requisition #:** 74565 **The Role at a Glance** As an Appeals Specialist you will be responsible for being a product subject matter ... for multiple product lines. You will perform and deliver on appeals claims assignments/projects while simultaneously leveraging and applying knowledge. You will… more
- Molina Healthcare (Yonkers, NY)
- …hours** Must be able to rotate weekends and holidays** Must have Medicare Appeals and IRE experience** **Job Summary** Responsible for reviewing and resolving member ... appeals and communicating resolution to members and provider (or...Responsible for the comprehensive research and resolution of the appeals , dispute, grievances, and/or complaints from Molina members, providers… more
- Molina Healthcare (Yonkers, NY)
- …to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine Provider No Surprises Act ... + Min. 2 years operational managed care experience (call center, appeals or claims environment). + Health claims processing background, including coordination… more
- Molina Healthcare (Yonkers, NY)
- …request authorization. Strongly prefer candidates with a background in appeals and grievances. Excellent computer multi-tasking skills and good productivity ... office with internet connectivity of high speed required **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical decisions for … more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front end operations of the Case Management Department by ... + 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
- CenterWell (Albany, NY)
- …caring community and help us put health first** The **Denials Management Specialist ** is responsible to respond to, monitor and analyze all governmental requests, ... to, managing and monitoring all payer requests for additional documentation (ADR), appeals and denials. Works with branch staff to gather required information and… more
- Staffing Solutions Organization (Albany, NY)
- …a reflection of our clients and the people they serve. **Senior Healthcare Program Specialist (Level 2 or 3) - Albany, NY** **Division of Eligibility & Marketplace ... the new eligibility system for New York's Complex Medicaid population, and the new appeals management system. The individual will act as a liaison between the DEMI… more
- Independent Health (Buffalo, NY)
- …fosters growth, innovation and collaboration. **Overview** The Clinical & Coding Specialist -Senior will be responsible for reviewing coding and clinical decisions on ... They will aid in training other team members, evaluating appeals , and share audit trends across the team. Expertise...audit tips across the team. The Clinical & Coding Specialist -Senior will support the leadership in Hospital Audit in… more
- Stony Brook University (East Setauket, NY)
- Revenue Specialist **Position Summary** At Stony Brook Medicine, a **Revenue Specialist ** will provide operational support within the hospital's Patient ... business functions including but not limited to: billing, claims analysis appeals , follow-up, financial assistance and customer service. **Duties of a Revenue… more
- Stony Brook University (East Setauket, NY)
- Revenue Specialist **Position Summary** At Stony Brook Medicine, a **Revenue Specialist ** will provide operational support within the hospital's Patient ... business functions including but not limited to: billing, claims analysis appeals , follow-up, financial assistance and customer service. **Duties of a Revenue… more