- CDPHP (Albany, NY)
- …for a rewarding career. Established in 1984, CDPHP is a physician -founded, member-focused, and community-based not-for-profit health plan that offers high-quality ... Clinical Manager will collaborate with the CDPHP team in the development, review and revision of CDPHP Resource Coordination policies, including internal and… more
- City of New York (New York, NY)
- …the Office of Medicaid Inspector General (OMIG), provider organizations (hospitals, physician groups and pharmacies), city agencies, client advocates, and MAXIMUS ... pace with these changes to ensure continued services to its consumers. Also review progress and performance reports submitted by the senior and supervisory staff for… more
- Rochester Regional Health (Rochester, NY)
- …deductibles and/or other types of payments; provide cost estimates when applicable; review charges in charge review WQs for completeness and accuracy ... Any physical requirements reported by a prospective employee and/or employee's physician or delegate will be considered for accommodations. PAY RANGE: $18.00… more
- Elderwood (Williamsville, NY)
- …care staff. + Evaluate resident on admission, obtain medical history, check physician orders, transfer and pre-admission information. Review resident's medical ... nursing representative for Department of Health matters. + Conduct assessments, review medical histories, and guide care planning from admission through discharge.… more
- Kaleida Health (Buffalo, NY)
- …Management, Quality Department and ancillary staff to perform concurrent analytical review of clinical documentation and coding data.The CDS facilitates obtaining ... of the health care team. The CDS is also responsible for audit review to identify potential documentation deficiencies in specific records and to identify clinical… more
- Rochester Regional Health (Rochester, NY)
- …to assist in developing operational budgets, analyzing and summarizing budgets for review meetings and participating in budget summary preparation for the Board of ... Directors + Analysis. Meet with assigned leaders monthly to review financial performance against static and flexible budgets and assist in identifying causes for… more
- Rochester Regional Health (Rochester, NY)
- …to assist in developing operational budgets, analyzing and summarizing budgets for review meetings and participating in budget summary preparation for the Board of ... Directors + Analysis. Meet with assigned leaders monthly to review financial performance against static and flexible budgets and assist in identifying causes for… more
- University of Rochester (Rochester, NY)
- …of the patient and clinical risk assessment, collateral information and review of current/percent history of clinical presentations/services. The clinical evaluator ... guardian, during the course of the evaluation in collaboration with the CPEP physician and CPEP Nursing staff. The Clinical Evaluator documents their evaluation and… more
- University of Rochester (Albany, NY)
- …billing system necessary to ensure balance resolution for all assigned URMFG physician services. + 25% Follows up on multi-faceted denials through review ... and coding. Escalates system issues preventing claims submission and follow-up for review and resolution. + 5% Collaborates with Claim Edit Specialists and Patient… more
- CDPHP (Albany, NY)
- …for a rewarding career. Established in 1984, CDPHP is a physician -founded, member-focused, and community-based not-for-profit health plan that offers high-quality ... diploma or GED required. + Minimum of (1) year claims examining procedural review experience utilizing CPT-4, HCPCS, and ICD-9 codes is highly preferred. +… more