- Mount Sinai Health System (New York, NY)
- …facilitates and tracks concurrent adverse determinations and collaborates with Appeals Management Department in managing retrospective denials . ... **Job Description** **Utilization Management Specialist MSH Case Management FT Days** This position...Days** This position is responsible for coordinating requests for clinical information from third party payers and providing support… more
- Garnet Health (Middletown, NY)
- …responsible for the day to day operation of the CDI department and DRG Denials appeals process. The Manager will develop, implement and evaluate processes, ... to make your career home with us as a CLinical Documnetaion Specialist on our CDI team... Documentation Improvement and Patient Access, the Manager of Clinical Documentation Integrity (CDI) and DRG Denials … more
- Excelsior Orthopaedics Group (Amherst, NY)
- …clarify documentation and ensure code accuracy. + Monitor and respond to coding-related denials , rejections, and edits; assist with appeals and identify areas ... CPT, ICD-10-CM, and HCPCS Level II codes for surgical and clinical procedures, ensuring accurate reimbursement, coding compliance, and efficient billing processes.… more
- Mohawk Valley Health System (Utica, NY)
- …+ Provide guidance and advisory services to physicians, case managers and clinical documentation specialist regarding correct level of care and reimbursement. ... potential barriers to patient discharge. The Physician Advisor (PA) conducts clinical review of cases to ensure compliance with regulatory requirements, hospitals… more
- University of Rochester (Rochester, NY)
- …referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non- clinical staff, identifying barriers to appointment ... company barriers and tracking all assistance provided. Accountable for planning, execution, appeals and efficient follow through on all aspects of the process which… more