- Cardinal Health (Albany, NY)
- …+ Must follow through on all benefit investigation rejections, including Prior Authorizations, Appeals , etc. All avenues to obtain coverage for the product must be ... documenting patient health insurance benefit investigations, prior authorizations, and appeals , preferred + Cell/Gene therapy and/or Oncology experience, preferred +… more
- Justice, Bureau of Prisons/Federal Prison System (New York, NY)
- …in security designations and custody classification. Experience entering and tracking appeals filed by inmates and assisting with researching and preparing responses ... to inmate appeals . Experience in providing assistance to contractors in the area of classification, programs, progress reports, parole procedures and other related… more
- Trinity Health (Syracuse, NY)
- …Business Service (PBS) centers; including analysis of clinical documentation, assist in appeals as needed, root cause analysis and tracking as needed. Educates ... errors accordingly. Epic experience desired. Experience and knowledge of working on appeals for insurance denials and identifying root cause. Knowledge of Hospital… more
- Trinity Health (Syracuse, NY)
- …Service (PBS) centers; including analysis of clinical documentation, assist in appeals as needed, root cause analysis and tracking as needed.Educates clinical ... errors accordingly. Epic experience desired.Experience and knowledge of working on appeals for insurance denials and identifying root cause.Knowledge of Hospital… more
- City of New York (New York, NY)
- …Corporation Counsel, various non-profits, and others. In this position, the Discovery Specialist is responsible for providing highly skilled support to CMS and the ... sentencing information/outcome. - Complete order to produce forms, surety forms, waiver of appeals , order of protections and other legal documents to be filed in… more
- CVS Health (Albany, NY)
- …**Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. - Applies medical ... written inquiries related to requests for pre-approval/pre-authorization, reconsiderations, or appeals . - Ensures all compliance requirements are satisfied and all… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Depending on the specific tasks assigned, the Medical Services Coordination Specialist provides administrative support for any of the programs of Utilization ... to care management programs + Provides administrative support to the grievance and appeals process within the + Medical Services department Level III (in addition to… more
- City of New York (New York, NY)
- …a period of growth and change. JOB DESCRIPTION The Board seeks a Standards Specialist ("Monitor") with a passion for justice, fairness, and human rights, and the ... - Assisting in processing, evaluating and preparing responses to appeals from people in custody concerning the Minimum Standards EXPERIENCE/QUALITIES/SKILLS… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Billing Specialist is responsible for multiple components of the billing & coding process, including Accounts Receivable, Charge Entry, Edits ... charge entry. 6. May run and work missing charges, edits, denials list and process appeals . Posts denials in EPIC/IDX on a timely basis. 7. Posts all payments in IDX… more
- Excelsior Orthopaedics Group (Amherst, NY)
- …Monitor and respond to coding-related denials, rejections, and edits; assist with appeals and identify areas for process improvement. + Collaborate with the billing ... Associate degree preferred. + Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification required. + Minimum of 1 year… more
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