- Northwell Health (Melville, NY)
- …current state, federal, and third-party payer regulations. Ensures clinical reviews and appeals are up to date and accurately reflect patient's severity of illness ... Skills 3-5 years experience in Utilization Review, Case Management, and Clinical Appeals . 3-5 years of acute inpatient clinical experience. Experience with MCG… more
- Molina Healthcare (Yonkers, NY)
- …subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for ... able to rotate weekends and holidays** Must have Medicare Appeals and IRE experience** Responsible for reviewing and resolving... appeals and denials . + Strong verbal and written communication skills To… more
- Molina Healthcare (Buffalo, NY)
- …for letters and prepare responses to appeals and grievances. + Elevates appropriate appeals to the Appeals Specialist . + Generates and mails denial ... by the Centers for Medicare and Medicaid. **KNOWLEDGE/SKILLS/ABILITIES** + Enters denials and requests for appeal into information system and prepares documentation… more
- Mount Sinai Health System (New York, NY)
- …Insurance requests) + Support Appeals Nurse / Manager by confirming status of denials + Tracking status of Medical Record requests for denials to insure that ... **Job Description** **Insurance Specialist MSH PT Days 4/Days Week (Days Vary)...to perform clinical/technical/service/administrative tasks: + Prioritizes Insurance Requests / Denials when received in the department as per protocol… more
- 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, ... Job Summary The Billing Specialist plays a critical part in maintaining the...narratives as needed. + Identify and report trends in denials , underpayments, and billing errors to support performance improvement.… more
- Stony Brook University (East Setauket, NY)
- Revenue Specialist **Position Summary** At Stony Brook Medicine, a **Revenue Specialist ** will provide operational support within the hospital's Patient ... business functions including, but not limited to: billing, claims analysis appeals , follow-up, financial assistance and customer service. **Duties of a Revenue… more
- Stony Brook University (East Setauket, NY)
- Revenue Specialist **Position Summary** At Stony Brook Medicine, a **Revenue Specialist ** will provide operational support within the hospital's Patient ... business functions including but not limited to: billing, claims analysis appeals , follow-up, financial assistance and customer service. **Duties of a Revenue… more
- 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 ... **Job Description** The Procedural Billing Specialist I is responsible for multiple components of the complex billing and coding process for specialized procedures,… more
- 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 ... fosters growth, innovation and collaboration. **Overview** The Clinical & Coding Specialist -Senior will be responsible for reviewing coding and clinical decisions on… more
- FlexStaff (Chappaqua, NY)
- …experience, specifically in anesthesia or similar specialties - Experience with claim appeals and denials - Strong organizational skills and meticulous attention ... Number** 163081 FlexStaff Our client is seeking a skilled Medical Biller/Accounts Receivable Specialist with a minimum of 2 years of experience in medical billing,… more