- Catholic Health (Buffalo, NY)
- …with varied hours based on role of management and oversight of team Summary: The Clinical Denials and Appeals , Clinical Supervisor is responsible for the ... people, carrying out and documenting the appeals process for denied claims denied due to reasons...denied due to reasons including, but not limited to clinical documentation/support for diagnostic related grouping (DRG) assignment, inpatient… more
- Garnet Health (Middletown, NY)
- …Health Medical Center. Responsibilities Under the direction of The Administrator, Coding & Clinical Documentation Improvement and Patient Access, the Manager of ... to make your career home with us as a CLinical Documnetaion Specialist on our CDI team at/in Garnet...day operation of the CDI department and DRG Denials appeals process. The Manager will develop, implement… more
- Molina Healthcare (Rochester, NY)
- …resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries/ Appeals . + Provides training and support to clinical ... Clinical Coder, Certified Medical Audit Specialists, Certified Case Manager , Certified Professional Healthcare Management, Certified Professional in Healthcare… more
- Mount Sinai Health System (New York, NY)
- …for assessment, communication and monitoring of discharge planning process (The clinical nurse initiates the discharge planning process on admission). ... **Job Description** **RN/Case Manager MSH Case Management PT Days** The Case...with physicians and managed care companies on concurrent denial appeals e. Communicates clinical information to the… 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 ... for appeals , On / Off-site Insurance reviews + Implements first step of appeals process to assist Appeals Nurse and Enter Denial information in… more
- Bassett Healthcare (Cooperstown, NY)
- …and enjoy the best quality of life possible. What you'll do The Case Manager RN supports the physician and interdisciplinary team in facilitating patient care, with ... the underlying objective of enhancing the quality of clinical outcomes and patient satisfaction while managing the cost of care and providing timely and accurate… more
- Memorial Sloan-Kettering Cancer Center (New York, NY)
- …Kettering Institute, scientists across MSK collaborate to conduct innovative translational and clinical research that is driving a revolution in our understanding of ... In this role, you will be responsible for evaluating and responding to clinical and administrative denials referred to Case Management Department for appeal. You… more
- Ellis Medicine (Schenectady, NY)
- …(SW). The Discharge Planner's primary function is to work with the Social Worker, Nurse Case Manager , or Utilization Management Nurse to facilitate patient ... Management with initial clinical review requests as needed. + Notifies Case Manager of any potential delays of moving the patient through the continuum. +… more
- University of Rochester (Rochester, NY)
- …considerations._ **Responsibilities:** GENERAL PURPOSE Under the direct supervision of the Practice Manager , Clinic Director and Nurse Manager works with ... meetings based on provider preferences or availability. + Works with Practice Manager , Fellowship Co-coordinator, and Clinical Directors to implement scheduling… more
- Catholic Health Services (West Islip, NY)
- …Registered Nurse (RN) License & Registration. + Certification: Care Manager Certification (CCM) preferred. Salary Range USD $172,500.00 - USD $220,000.00 /Yr. ... not limited to, Medical Staff, Quality/Risk Management, CH Utilization and Central Appeals , Managed Care and Revenue Cycle and Patient Access departments to ensure… more