- CVS Health (Albany, NY)
- …written inquiries related to requests for pre-approvals/pre-authorizations, reconsiderations, or appeals . + Ensures all compliance requirements are satisfied and ... that all payments are made following company practices and procedures. + Review and handle relevant correspondences assigned to the team that may result in adjustment to claims. + May provide job shadowing to lesser experience staff. + Utilize all resource… more
- Intermountain Health (Albany, NY)
- …providers, clinical staff, compliance and the CDI team. + Audits and creates appeals for all payer and regulatory denials and downgrades and provides in-depth coding ... review, audit findings, and appeal strategies. + Develops and implements training plans for all internal stakeholders including coders at all levels, providers, clinical staff, compliance and the CDI team. + Audits clinical documentation and coding for complex… more
- Monroe Community College (Rochester, NY)
- …activities and interventions, including review of Satisfactory Academic Progress appeals and targeted follow-up, assessment of student compliance with Financial ... Aid Course Eligibility (FACE), fresh start application review, and connecting with students on caseload who have withdrawn or are considering withdrawing + Report on persistence, retention, and completion objectives of assigned caseload + Connect students with… more
- New York Health Care (Valley Stream, NY)
- …necessary adjustments, while communicating these changes to the contract and filing appeals when necessary. + Correct system issues pertaining to billing, patients ... and or caregivers as directed by management. + Requirements: + Previous collections experience with proven results. + Strong analytic skills with advanced problem solving ability. + Excellent organizational skills with attention to detail. + Intermediate… more
- University of Rochester (Rochester, NY)
- …edits and obtains signatures for non-routine letters of correspondence related to appeals on denied claims. This includes compiling all necessary information and ... drafts for provider signature. - Manages provider(s) documentation and information. Composes and types non routine correspondence providing factual information. - Arranges travel, conference registration and hotel accommodations. Interfaces with organizations,… more
- Rochester Regional Health (Rochester, NY)
- …requests for cardiology medications, and monitor approvals, step therapy requirements, and appeals to ensure timely access to treatment. + Collaborate with providers ... to gather clinical documentation and assist patients with enrollment in pharmaceutical assistance programs, grants, and co-pay support. + Maintain current knowledge of manufacturer programs, eligibility criteria, and track patient enrollment and renewal… more
- Mohawk Valley Health System (Utica, NY)
- …and advisory services to physicians, case managers and clinical documentation specialist regarding correct level of care and reimbursement. Apply knowledge of ... throughout the medical staff. + Assist case managers with Medicare and Medicaid appeals and Administrative Law Judge (ALJ) testimonies. Act as a liaison with payers… more
- WMCHealth (Valhalla, NY)
- …Job Details: Job Summary: The Senior Inpatient Coder is responsible for addressing appeals to insurance companies and coding highly complex medical records using the ... role is expected. Does related work as required. Responsibilities: + Addresses appeals to insurance denials to facilitate expedient resolution and reimbursement. +… more
- Garnet Health (Middletown, NY)
- …we invite to make your career home with us as a CLinical Documnetaion Specialist on our CDI team at/in Garnet Health Medical Center. Responsibilities Under the ... the day to day operation of the CDI department and DRG Denials appeals process. The Manager will develop, implement and evaluate processes, policies and procedures… more
- City of New York (New York, NY)
- Job Description APPLICANTS MUST BE PERMANENT IN THE ADMINISTRATIVE CONTRACT SPECIALIST CIVIL SERVICE TITLE OR BE PERMANENT IN A COMPARABLE TITLE ELIGIBLE FOR 6.1.9 ... to treatment and application assistance with the federal disability application and appeals processes as appropriate. Under the general direction of the Director of… more
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