- Mount Sinai Health System (New York, NY)
- …in the department as per protocol + Requests or provides Medical Records as required for appeals , On / Off-site Insurance reviews + Implements first step of ... information in Allscripts + Meets time frame for reviews / appeals as specified by Insurance / State & Federal regulation. + Enters concurrent review information… more
- Catholic Health Services (Melville, NY)
- …advisors and facility departments. + Develops/validates daily work lists for Utilization and Appeals Manager. + Assist with all insurance and regulatory audits ... Island's Top Workplace! Job Details Position Summary: The Utilization and Appeals Coordinator will perform activities to help facilitate utilization management and… more
- Evolent (Albany, NY)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a meaningful impact as part of ... a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and… more
- MTA (Brooklyn, NY)
- Assistant General Counsel III - Appeals , Torts Job ID: 12066 Business Unit: New York City Transit Location: Brooklyn, NY, United States Regular/Temporary: Regular ... Posted: Jul 10, 2025 Description Job Information Assistant General Counsel III - Appeals , Torts First Date of Posting: 7/10/2025 Last Date of Filing: Until Filled… more
- Centene Corporation (New York, NY)
- …Friday.** **Position Purpose:** Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical ... + Communicates with members, providers, facilities, and other departments regarding appeals requests + Generates appropriate appeals resolution communication and… more
- MTA (Brooklyn, NY)
- Executive Agency Counsel, Appeals Job ID: 12747 Business Unit: MABSTOA Location: Brooklyn, NY, United States Regular/Temporary: Regular Department: Torts Date ... 27, 2025 Description Job Information Executive Agency Counsel, Non-Managerial (Level A & B)- Appeals First Date of Posting: 8/19/2025 Last Date of Posting: Open Until… more
- Humana (Albany, NY)
- …a part of our caring community and help us put health first** The Appeals Representative 4 - IRT (Internal Review Team) Investigates and resolves member and ... documentation to determine if an appeal or further request is warranted. The Appeals Representative 4 IRT (Internal Review Team) + Review documents + Building cases… more
- Cognizant (Albany, NY)
- …. Maintain working knowledge of applicable health insurers' internal claims, appeals , and retro-authorization as well as timely filing deadlines and processes. ... Medicare, Medicaid, and third-party guidelines. . Effectively document and log claims/ appeals information on relevant tracking systems . Utilize critical thinking… more
- CenterWell (Albany, NY)
- …our caring community and help us put health first** The Grievances & Appeals Representative 3 manages client denials and concerns by conducting a comprehensive ... with clinical and other Humana parties. The Grievances & Appeals Representative 3 performs advanced administrative/operational/customer support duties that require… more
- Lincoln Financial (Albany, NY)
- …for this opportunity. **Requisition #:** 74565 **The Role at a Glance** As an Appeals Specialist you will be responsible for being a product subject matter expert to ... for multiple product lines. You will perform and deliver on appeals claims assignments/projects while simultaneously leveraging and applying knowledge. You will… more