• Registered Nurse or Physical Therapist…

    CenterWell (Albany, NY)
    …responding to, managing and monitoring all payer requests for additional documentation (ADR), appeals and denials . Works with branch staff to gather required ... to develop appropriate and timely responses. + Responsible for constructing response to denials and appeals , utilizing any federal guidelines or local coverage… more
    CenterWell (07/30/25)
    - Related Jobs
  • Appeals Manager

    BronxCare Health System (Bronx, NY)
    …best respond to all hospital denials notification and documentation efforts. The Appeals Manager will provide timely tracking and trending of all denials ... and Appeals Coordinators, Physician Advisors, and the clinical staff, the Appeal Manager is responsible...to assist the department attain its objective of managing denials and appeals . Responsibilities - Types, utilizing… more
    BronxCare Health System (06/21/25)
    - Related Jobs
  • Inpatient Clinical & Coding Specialist…

    Independent Health (Buffalo, NY)
    …coding guidelines and financial policies/contracts. + Responsible for all reconsideration clinical appeals to include review of records, consultation with ... Specialist (CCDS), American Health Information Management Association (CCS-H, CCS-P), Certification Denials and Appeals Management (C-DAM), or NYS licensed RN… more
    Independent Health (07/15/25)
    - Related Jobs
  • Insurance Specialist-Mount Sinai West-Utilization…

    Mount Sinai Health System (New York, NY)
    …Discharge Appeals / Insurance requests) + Support Appeals Nurse / Manager by confirming status of denials + Tracking status of Medical Record requests ... Clinical /Technical/Service** + Demonstrates the ability to perform clinical /technical/service/administrative tasks: + Prioritizes Insurance Requests / Denials more
    Mount Sinai Health System (07/23/25)
    - Related Jobs
  • Case Manager - Per Diem

    Stony Brook University (Stony Brook, NY)
    Case Manager - Per Diem **Position Summary** At Stony...the hospital stay. + Assist with coverage for UR, Appeals and denials + Actively involved in ... Brook Medicine, a **Case Manager ** is a valuable member of our team, who...is a valuable member of our team, who provides clinical services to our patient population. Qualified candidates will… more
    Stony Brook University (07/09/25)
    - Related Jobs
  • Registered Nurse (RN) - Utilization Management

    Rochester Regional Health (Rochester, NY)
    …RESPONSIBILITIES: + Review standard UM sources for potential inpatient medical necessity denials . Review patient class in the event manager , assist with ... or no appeal is necessary per UM reviews. + Track and monitor all denials , appeals , arbitration responses to payers/audits. + Participates in periodic denial… more
    Rochester Regional Health (08/02/25)
    - Related Jobs
  • Field Reimbursement Manager

    Amgen (New York, NY)
    …supporting the entire reimbursement journey through payer prior authorization to appeals / denials requirements and forms + Review patient-specific information in ... lives of patients while transforming your career. **Field Reimbursement Manager - New York** **What you will do** Let's...third-party access arena or pharmaceutical industry in managed care, clinical support, and/or sales OR Master's degree AND 6… more
    Amgen (07/25/25)
    - Related Jobs
  • Director of Care Coordination

    Catholic Health Services (West Islip, NY)
    …not limited to, Medical Staff, Quality/Risk Management, CH Utilization and Central Appeals , Managed Care and Revenue Cycle and Patient Access departments to ensure ... the most advantageous clinical and financial outcomes. Supports all CH and consultant...consultant initiatives addressing activities relative to Care Management and Denials . Identifies opportunities for improvement that result in development… more
    Catholic Health Services (07/18/25)
    - Related Jobs