- City of New York (New York, NY)
- …from the Contract Monitoring unit, summarizing the justifications of approvals and denials , and data collected to process provider appeals for individual ... and invoice issues; reviews and takes the appropriate action for provider appeals related to performance-based payment and/or credit by conducting research through… more
- City of New York (New York, NY)
- …Assurance and/or Contract Monitoring unit, summarizing the justifications of approvals and denials , and data collected to process provider appeals for individual ... and invoice issues; reviews and takes the appropriate action for provider appeals related to performance-based payment and/or credit by conducting research through… more
- Mount Sinai Health System (Long Island City, NY)
- …will direct and manage departmental activities involved in utilization review, appeals management and discharge planning to facilitate the case management process ... external agencies, Physician 9.Advisors and the Medical Director. 10.Ensures Discharge Appeals functions are carried out within contractual, federal and state… more
- University of Rochester (Rochester, NY)
- …compliance, insurance company barriers and tracking all assistance provided. Plans, executes, appeals and follows through on all aspects of the process which has ... insurance company by applying knowledge and experience of previous authorization requests, denials , and approvals. + On behalf of the provider and the University,… more
- University of Rochester (Albany, NY)
- …assigned URMFG physician services. + 25% Follows up on multi-faceted denials through review of remittances (EOBs), insurance correspondence, rejections received thru ... claims. Collaborate with appropriate departments to generate a detailed rational for appeals and grievances to the insurance companies. + 10% Keeps management… more
- University of Rochester (Rochester, NY)
- …company barriers and tracking all assistance provided. Accountable for planning, execution, appeals and efficient follow through on all aspects of the process which ... insurance company by applying knowledge and experience of previous authorization requests, denials and approvals. On behalf of the provider and the University,… more
- Catholic Health Services (West Islip, NY)
- …not limited to, Medical Staff, Quality/Risk Management, CH Utilization and Central Appeals , Managed Care and Revenue Cycle and Patient Access departments to ensure ... and consultant initiatives addressing activities relative to Care Management and Denials . Identifies opportunities for improvement that result in development of… more
- Catholic Health Services (Roslyn, NY)
- …Job Details Responsible for providing support to the Care Management and Denials Management Departments functions and staff, include the clerical support for Care ... services when required. Assembles and facilitates paperwork for QIO expedited appeals . Distributes census, reports required for Care Management staff. Orders… more