- Saratoga Hospital (Saratoga Springs, NY)
- …services from payers. This position provides a vital link between inpatient coding, clinical documentation improvement , Patient Access (PA) and Patient ... general supervision of the Manager, Health Information Services, the Denials Specialist performs activities to ensure appropriate financial reimbursement for HIS… more
- St. Mary's Healthcare (Amsterdam, NY)
- …activations. + Identifies opportunities to maximize the accuracy and effectiveness of clinical documentation for emergency response activations( RRT and Code ... Blue) as well as documentation requirements for the CMS- SEP-1 measure. + Facilitate...and patient care teams, with respect to resuscitation performance improvement initiatives. + Uses clinical practice experience… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front end operations of the Case Management Department by ... individuals. Must also maintain accurate record keeping via either electronic documentation within the hospital Eagle and Canopy systems or written record… more
- Excelsior Orthopaedics Group (Amherst, NY)
- …every day. + Accurately review and abstract information from operative and clinical documentation to assign appropriate diagnosis and procedure codes for ... CPT, ICD-10-CM, and HCPCS Level II codes for surgical and clinical procedures, ensuring accurate reimbursement, coding compliance, and efficient billing processes.… more
- Trinity Health (Syracuse, NY)
- …clinical background and referral needs. Per referral guidelines, provide appropriate clinical information to specialist . + Call patient with appointment ... .To be world-renowned for passionate patient care and outstanding clinical outcomes. **Core Values:** .In the spirit of good...of all referrals into database. + Verify all pertinent documentation has been provided for the type of referral… more
- Arnot Health (Bath, NY)
- …Ira Davenport Memorial Hospital is seeking a compassionate and skilled licensed Social Work Specialist II to join our team. This position plays a vital role in ... with interdisciplinary staff, both internal and external, the Social Work Specialist II contributes to complex case management, patient advocacy, and quality… more
- Mount Sinai Health System (New York, NY)
- …for clarification of documentation if required. 3.Participates in the documentation improvement process on conjunction with Coding management and leadership. ... of diagnoses and procedures. The coded data is utilized for reimbursement, clinical care assessment, education, research, case mix and health care statistical… more
- Richmond Community Services (Yonkers, NY)
- Richmond Community Services is seeking a dedicated and compassionate Behavior Intervention Specialist (BIS) to join our team. In this role, you will develop and ... committees to ensure coordinated care + Participate in team meetings, quality improvement initiatives, and staff development sessions + Maintain accurate and timely … more
- Molina Healthcare (Syracuse, NY)
- **Job Description** **Job Summary** The Sr Specialist , Provider Engagement role implements Health Plan provider engagement strategy to achieve positive quality and ... Molina risk adjustment and quality efforts (eg Supplemental data, EMR connection, Clinical Profiles programs) and use of the Molina Provider Collaboration Portal. *… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …or without notice. Primary Responsibilities + Thorough review of claims and medical documentation . + Prepare cases for clinical review. + Resolve and provide ... Brighton Health Plan Solutions (BHPS) is seeking an experienced Claim Dispute Specialist skilled in investigating and resolving provider payment disputes by our… more