- Mount Sinai Health System (New York, NY)
- …touches, aged AR trends and billing lags. + Collaborate with department such as coding , IT, clinical service areas and appeals to ensure seamless end-to-end ... across departments (eg, DTP, Human Resources, Managed Care, Finance, and clinical departments) + Collaborates with finance, managed care and DTP contributors… more
- Rochester Regional Health (Rochester, NY)
- …as federal, state and payer-specific regulations and policies pertaining to documentation, coding and billing. + Demonstrates advanced clinical expertise and ... Job Title: Director, CDI Department: Clinical Documentation ImprovementLocation: Riedman CampusHours Per Week: 40Schedule: Monday - Friday, 8am - 4:30pmSUMMARY The … more
- Molina Healthcare (Syracuse, NY)
- JOB DESCRIPTION **Job Summary** The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests are ... regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Assesses appropriateness of services, length of stay and… more
- SUNY Upstate Medical University (Syracuse, NY)
- …all endoscopy and procedural procedures and assures that all of the appropriate clinical , equipment and insurance coding information is collected for the surgery ... schedule. Scheduler receives requests to schedule procedures from physician offices and schedules the procedure according to established guidelines and policies. Scheduler provides accurate information so that all departments may view daily, and maintains open… more
- Humana (Albany, NY)
- …these may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and ... and work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal… more
- Humana (Albany, NY)
- …discussions with an external provider. Some roles include an overview of coding practices and clinical documentation, dispute/grievance and appeals processes, ... and work is assisted by diverse resources, which may include national clinical guidelines, CMS policies and determinations, clinical reference materials,… more
- Humana (Albany, NY)
- …may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, dispute, grievance, and appeals processes, ... and work is assisted by diverse resources, which may include national clinical guidelines, CMS and state policies and determinations, clinical reference… more
- Catholic Health Services (Smithtown, NY)
- …- to every resident and patient, every time. Job Details Summary: The Clinical Reimbursement and Quality Management plays a vital role in ensuring accurate ... care and ensuring compliance with regulatory standards. Key Responsibilities: Clinical Reimbursement: + Documentation: Review and analyze resident documentation to… more
- BronxCare Health System (Bronx, NY)
- Overview The Clinical Documentation Specialist will work with Senior Director in physician education regarding documentation that meets severity of illness/intensity ... hospital top DRG's to insure that documentation is optimal and meets coding clinic guidelines in order insure optimal hospital reimbursement. Prepares and presents… more
- Catholic Health (Buffalo, NY)
- …evening and weekends coverage as needed Summary: The Middle Revenue Cycle - Clinical Supervisor, as an active member of the Middle Revenue Cycle and ... team and works in conjunction with the Utilization Review Manager and Manager Clinical Documentation Integrity. The Middle Revenue Cycle - Clinical Supervisor is… more