- Crouse Hospital (Syracuse, NY)
- …Managers in the department, including Utilization Management, Discharge Planning and Denials and Appeals functions. + Assessing workflow related to readmission ... Business Office staff regarding workflow processes and maintains an effective denials management process. + General operational oversight includes hiring, training… more
- Mount Sinai Health System (New York, NY)
- …entry of codes. + Posts all payments in IDX. Runs and works missing charges, edits, denials list and processes appeals. Posts denials in IDX on a timely basis. + ... Provides comprehensive denial management to facilitate cash flow. Tracks, quantifies and reports on denied claims. + Directs and assists with responses to problems or questions regarding benefit eligibility and reimbursement procedures. + Researches… more
- Centene Corporation (New York, NY)
- …coordinate the medical affairs functions for the business unit. Oversee the denials and appeals department. May manage other medical directors. Assume VPMA ... hoc committees. + May oversee all aspects of the Appeals and Denials department including implementing budgetary, policy, and personnel decisions for the department.… more
- Mount Sinai Health System (Elmhurst, NY)
- …and/or meet with physicians regarding documentation and deficiencies. Review edits, denials and requests for additional information from the accounts receivable team ... on edit list and/or requests for additional information as to reduce denials and accounts receivable. Attends various classes, seminars or trainings to keeping… more
- Trinity Health (Syracuse, NY)
- …+ Lead initiative on point-of-service collections at each office. + Review denials and identify areas needing improvement. + Work closely with office management ... Work closely with the CBO to automate insurance verifications and reduce denials . + Coordinate and communicate schedule changes to physicians, managers and… more
- The Institute for Family Health (New Paltz, NY)
- …Explanation of Benefits for designated accounts and posts payments and denials accurately upon receipt. + Provides clerical support to senior representatives ... professionals and patients on daily basis. + Recognizes issues relating to claims denials and communicates such information in a timely manner to the manager of… more
- Mount Sinai Health System (New York, NY)
- …in accordance with policies and procedures. 3. May run and work missing charges, edits, denials list and process appeals. Posts denials in IDX on a timely basis. ... 4. Posts all payments in IDX using approved methodologies. 5. May perform specialty coding for services and medical office visits and review physician coding and provide updates to physicians and staff. 6. Works TES, BAR and eCommerce edits for the division,… more
- Trinity Health (Troy, NY)
- …and report findings * Upon identification of possible concurrent denials , forwards information to the appropriate Utilization Management/Concurrent Review Nurse ... within identified process standards * Reviews any service denials and gathers necessary supporting documentation from chart audits and follows up according to… more
- Catholic Health Services (Bethpage, NY)
- …responding to requests for reviews in a timely fashion to avoid denials . Review records and collaborate with the interdisciplinary team to obtain information ... the patients, transmitting information to third party payors to avoid denials . Participate in interdisciplinary rounding and identify areas for improvement.… more
- Stony Brook University (East Setauket, NY)
- …but are not limited to:** + Prepare and submit hospital claims. Review denials . Investigate coding issue. Audits. + Follow-up on rejected or denied claims, improper ... claims/insurance companies and review to increase revenue and prevent unnecessary denials . + Assist the supervisor in scheduling, timesheet, leave requests,… more