- Elevance Health (Middletown, NY)
- …requests. + Refers cases requiring clinical review to a Nurse reviewer . + Responsible for the identification and data entry of referral requests into ... I** is responsible for coordinating cases for precertification and prior authorization review . **How will you make an impact:** + Managing incoming calls or… more
- Centene Corporation (New York, NY)
- …such as history, diagnosis, and prognosis based on the referral to the clinical reviewer for determination + Remains up-to-date on healthcare, authorization ... the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified,… more
- BronxCare Health System (Bronx, NY)
- Overview Review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10-CM and CPT-4 codes for billing, ... more clarification. - Inputs all codes and other required data into the clinical information system for accurate APC, EAPG assignments. Identifies non-payment… more
- Mount Sinai Health System (New York, NY)
- …standards and protocols. + Responsible for a comparison review of collected data and scans of original clinical consent documents that are sent to ... of the consent documents sent by the WTC Health Program Clinical Centers of Excellence to the Data Center. + Assures all logged activities and completed work is… more
- Fresenius Medical Center (Fairport, NY)
- …ongoing participation in Continuous Quality Improvement (CQI) activities. + Enters all treatment data into the designated clinical application in an accurate and ... Related** + Participates in the recruitment process for new clinical staff + Assists with clinical orientation...timely manner. + Review treatment sheets for completeness, ensure nursing signatures are… more
- Fresenius Medical Center (Syracuse, NY)
- …ongoing participation in Continuous Quality Improvement (CQI) activities. + Enters all treatment data into the designated clinical application in an accurate and ... RELATED:** + Participates in the recruitment process for new clinical staff. + Assists with clinical orientation...timely manner. + Review treatment sheets for completeness ensure nursing signatures are… more
- CVS Health (Albany, NY)
- …purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and ... conditions + Diagnosis codes must be appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and internal… more
- University of Rochester (Rochester, NY)
- …determined by considering factors including, but not limited to, market data , education, experience, qualifications, expertise of the individual, and internal equity ... with Program Directors, Managers, and Supervisors in Administrative Services; Data Analysts; Chaplaincy Services; Communications Center; Financial Case Management;… more
- Whitney Young Health Center (Albany, NY)
- …functions regarding payer and pharmaceutical contractual requirements (adverse event reporting, data and inventory reporting, clinical management). + Reaffirms ... Description GENERAL RESPONSIBILITIES: The Staff Pharmacist offers preventive and clinical healthcare services, including immunizations and patient centered … more
- City of New York (New York, NY)
- …to notified partners. - Connect persons with a new HIV diagnosis with HIV to clinical care. - Use HIV transmission network data to identify and reach out ... new HIV diagnosis and clients not in care to clinical care, assess clients for medical and social services...on HIV cases to fulfill surveillance and case investigation data requirements, including medical record review , patient,… more