• Clinical Denials & Appeals Specialist

    Northwell Health (Melville, NY)
    …and knowledge gaps. Job Responsibility Serves as liaison between the patient and facility/ physician and the third party payer. Prepares and defends level of care and ... medical necessity for assigned case. Collaborates with physician advisor, payor representative and site case managers to facilitate appropriate level of care… more
    Northwell Health (08/20/25)
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  • Field Medical Director, Oncology

    Evolent (Albany, NY)
    …interacts with leadership and management staff, other Physicians, and staff whenever a physician `s input is needed or required. **What You Will Be Doing:** . Serve ... as the Physician match reviewer in Advanced Imaging cases, that do...rationale for standard and expedited appeals. . Utilizes medical/clinical review guidelines and parameters to assure consistency in the… more
    Evolent (08/19/25)
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  • Business Office Representative

    Rochester Regional Health (Rochester, NY)
    …Regional Health is an Equal Opportunity/Affirmative Action Employer. Minority/Female/ Disability /Veterans by a prospective employee and/or employee's Physician ... continually looking for ways to improve a complex business process. RESPONSIBILITIES: + Review and accurately process claim edits in a system work queue. Accurately… more
    Rochester Regional Health (08/17/25)
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  • RN - Cfss - Hybrid Schedule (Home Care RN…

    HCR Home Care (Plattsburgh, NY)
    …computer software. Notify staff, as appropriate, to ensure proper coordination of care. + Review and approve all interim orders before they are sent to physician ... route to Medical Records to be sent to the physician for signature. Ensure any corrections are made by...MRS is unable to retrieve the unsigned order. + Review and follow-up on entitlement verification issues. + Verify/Ensure… more
    HCR Home Care (08/16/25)
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  • Field Medical Director , Radiology (Urology)

    Evolent (Albany, NY)
    …interacts with leadership and management staff, other Physicians, and staff whenever a physician `s input is needed or required. **What You Will Be Doing:** + Serve ... as the Physician match reviewer in Imaging cases, that do not...rationale for standard and expedited appeals. + Utilizes medical/clinical review guidelines and parameters to assure consistency in the… more
    Evolent (08/02/25)
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  • Dental Hygienist (Per Diem) | Riedman Health…

    Rochester Regional Health (Rochester, NY)
    …Regional Health is an Equal Opportunity/Affirmative Action Employer. Minority/Female/ Disability /Veterans by a prospective employee and/or employee's Physician ... Sterilization department in maintaining the flow of instruments between departments. + Review and confirm patient's medical history and note changes in medical… more
    Rochester Regional Health (07/25/25)
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  • Field Medical Director, Physical Medicine…

    Evolent (Albany, NY)
    …interacts with leadership and management staff, other Physicians, and staff whenever a physician `s input is needed or required. **What You Will Be Doing:** + Serve ... as the Physician match reviewer in PM&R cases, that do not...rationale for standard and expedited appeals. + Utilizes medical/clinical review guidelines and parameters to assure consistency in the… more
    Evolent (07/24/25)
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  • Director of Nursing

    OLV Human Services (Lackawanna, NY)
    …life insurance + Supplemental insurance programs for additional life insurance, short-term disability , accident & cancer insurance + Up to $600 every year for ... staff, as well as team meetings to share best practices, policy updates, review OPWDD regulations and any additional supports. 7. Provides education on medical… more
    OLV Human Services (07/11/25)
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  • RN Case Manager - Assisted Living Memory Care…

    Rochester Presbyterian Home (Rochester, NY)
    …Ensure quality of care through regular daily reviews of required documentation, physician 's orders, chart audits, and overall individual service plan completion and ... review . + Observe signs and symptoms and report to the physician reactions to treatments, including drugs and changes in the patient's physical or emotional… more
    Rochester Presbyterian Home (06/26/25)
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  • Business Office Representative

    Rochester Regional Health (Rochester, NY)
    …Regional Health is an Equal Opportunity/Affirmative Action Employer. Minority/Female/ Disability /Veterans by a prospective employee and/or employee's Physician ... a complex business process. STATUS: LOCATION: DEPARTMENT: SCHEDULE: Key Responsibilities: + Review and accurately process claim edits in a system work queue.… more
    Rochester Regional Health (06/25/25)
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