• Appeals Manager

    BronxCare Health System (Bronx, NY)
    Overview Assists in the analysis and preparation of responses to payor denials and develop strong appeals for the purpose of securing reimbursement for acute ... action in order to improve outcomes. - Maintains an excel log related to denials / appeals activities in order to monitor successful appeals . - Assists with… more
    BronxCare Health System (06/21/25)
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  • Insurance Specialist-Mount Sinai West-PT 4/Days…

    Mount Sinai Health System (New York, NY)
    …Discharge Appeals / Insurance requests) + Support Appeals Nurse / Manager by confirming status of denials + Tracking status of Medical Record requests ... ability to perform clinical/technical/service/administrative tasks: + Prioritizes Insurance Requests / Denials when received in the department as per protocol +… more
    Mount Sinai Health System (08/12/25)
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  • Case Manager - Case Management

    Arnot Health (Elmira, NY)
    …Arnot Health departments and third party payers to discourage preventable denials DUTIES AND RESPONSIBILITIES: 1. Retrospectively determines medical necessity and ... admission and stay in accordance with InterQual Criteria to assist with appeal of denials 2. Maintains a working knowledge of the requirements of 3rd party payers 3.… more
    Arnot Health (08/08/25)
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  • Case Manager - Per Diem

    Stony Brook University (Stony Brook, NY)
    Case Manager - Per Diem **Position Summary** At Stony...the hospital stay. + Assist with coverage for UR, Appeals and denials + Actively involved in ... Brook Medicine, a **Case Manager ** is a valuable member of our team, who...Active participation with the physician and payer to prevent denials . Reviews cases for potential change in level of… more
    Stony Brook University (07/09/25)
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  • Manager Case Management (Registered Nurse)

    Crouse Hospital (Syracuse, NY)
    …Care Managers in the department, including Utilization Management, Discharge Planning and Denials and Appeals functions. + Assessing workflow related to ... health education and outreach programs. Crouse's Care Coordination team is hiring a Manager who is responsible for providing day to day management of the RN… more
    Crouse Hospital (08/08/25)
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  • Procedural Billing Specialist I - Surgery

    Mount Sinai Health System (New York, NY)
    …data 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 ... Specialist works directly with the Department Administrator. Reports to Billing Manager /Revenue Cycle Manager . **Qualifications** + Associates Degree preferred +… more
    Mount Sinai Health System (08/08/25)
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  • Senior Inpatient Coder (Remote)

    WMCHealth (Valhalla, NY)
    …role is expected. Does related work as required. Responsibilities: + Addresses appeals to insurance denials to facilitate expedient resolution and reimbursement. ... Job Details: Job Summary: The Senior Inpatient Coder is responsible for addressing appeals to insurance companies and coding highly complex medical records using the… more
    WMCHealth (08/19/25)
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  • Billing Specialist

    Excelsior Orthopaedics Group (Amherst, NY)
    …status using payer portals and billing software; investigate and resolve rejections or denials promptly. + Prepare and submit appeals for denied claims, ... narratives as needed. + Identify and report trends in denials , underpayments, and billing errors to support performance improvement....on past due accounts as directed by the Billing Manager . + Maintain strict confidentiality of patient health and… more
    Excelsior Orthopaedics Group (08/22/25)
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  • Inpatient Clinical & Coding Specialist - Senior

    Independent Health (Buffalo, NY)
    …Specialist (CCDS), American Health Information Management Association (CCS-H, CCS-P), Certification Denials and Appeals Management (C-DAM), or NYS licensed RN ... They will aid in training other team members, evaluating appeals , and share audit trends across the team. Expertise...and Accountable. **Essential Accountabilities** + Assume role of project manager as it relates to the re-engineering of the… more
    Independent Health (07/15/25)
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  • Discharge Planner

    Ellis Medicine (Schenectady, NY)
    …MIDAS per policy. + Prints/copies the chart to fax or send for insurance denials or quality improvement organization appeals . + Assists UM Coordinator with data ... is to work with the Social Worker, Nurse Case Manager , or Utilization Management Nurse to facilitate patient discharge...entry of insurance authorizations and denials . + Denial Management Activities + Assists Denial Management… more
    Ellis Medicine (08/28/25)
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