• Clinical Reimbursement Manager; HSO Drg…

    Mount Sinai Health System (New York, NY)
    …the physician documentation for specificity, completeness and quality to support coding accuracy, and to identify physician query opportunities to improve the ... documentation. The CRM will follow the official coding rules, guidelines and conventions to validate coded data and ensure high quality and compliance with… more
    Mount Sinai Health System (07/17/25)
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  • Director, Clinical Documentation…

    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
    Rochester Regional Health (07/04/25)
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  • Medical Director- South Central

    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,… more
    Humana (07/11/25)
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  • Medical Director - Gulf South

    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 (07/08/25)
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  • Medical Director - Mid West Region

    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,… more
    Humana (05/14/25)
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  • Clinical Reviewer

    Independent Health (Buffalo, NY)
    …and a culture that fosters growth, innovation and collaboration. **Overview** The Clinical Reviewer will be responsible for the collection and review of medical ... of a high performing health plan and physician network. The Clinical Reviewer will investigate quality complaints/grievances and appeals, document research of… more
    Independent Health (07/09/25)
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  • Director Clinical and DRG Denials

    Kaleida Health (Buffalo, NY)
    **Director Clinical and DRG Denials** **Location:** Larkin Bldg @ Exchange Street Location of Job: US:NY:Buffalo Work Type: Full-Time **Shift:** Shift 1 Job ... Description **Summary:** The Director, Clinical & DRG Denials provides clinical leadership and administrative guidance to the Clinical Revenue Cycle… more
    Kaleida Health (06/19/25)
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  • Analyst, Clinical Rules Management

    Evolent (Albany, NY)
    …for the mission. Stay for the culture. **What You'll Be Doing:** ** Clinical Rules Management, Analyst** Seeking a detail-oriented ** Clinical Rules Management, ... role in ensuring the accuracy and integrity of our clinical rule engine, impacting our clinical review...excellent interpersonal skills + Knowledge of ICD-10 and CPT coding assignments for billing in an outpatient or physician… more
    Evolent (06/19/25)
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  • Psychiatry - Clinically Trained Post-Doctoral…

    Mount Sinai Health System (New York, NY)
    …is seeking a highly motivated clinically trained post-doctoral fellow to conduct clinical and translational research!** The Icahn School of Medicine at Mount Sinai ... seeking a highly motivated clinically trained post-doctoral fellow to conduct clinical and translational research in psychosis spectrum disorders or mood disorders.… more
    Mount Sinai Health System (05/20/25)
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  • Dialysis Clinical Manager Registered Nurse…

    Fresenius Medical Center (Jamaica, NY)
    …requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory ... and FMS patient care and administrative policies as the clinical leader, has the authority to make daily decisions...completion of the Annual Standing Order Review and ICD coding . + Checks correspondence whether electronic, paper or voice… more
    Fresenius Medical Center (07/17/25)
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