- WMCHealth (Valhalla, NY)
- …Job Details: Job Summary: The Senior Inpatient Coder is responsible for addressing appeals to insurance companies and coding highly complex medical records using ... role is expected. Does related work as required. Responsibilities: + Addresses appeals to insurance denials to facilitate expedient resolution and reimbursement.… more
- Trinity Health (Syracuse, NY)
- …charge errors accordingly. Epic experience desired. Experience and knowledge of working on appeals for insurance denials and identifying root cause. Knowledge of ... Business Service (PBS) centers; including analysis of clinical documentation, assist in appeals as needed, root cause analysis and tracking as needed. Educates… more
- Trinity Health (Syracuse, NY)
- …charge errors accordingly. Epic experience desired.Experience and knowledge of working on appeals for insurance denials and identifying root cause.Knowledge of ... Service (PBS) centers; including analysis of clinical documentation, assist in appeals as needed, root cause analysis and tracking as needed.Educates clinical… more
- Elderwood (Waverly, NY)
- …phone calls) with case managers to provide concurrent updates as requested by Insurance Companies, handles Third Party appeals , peer to peers as applicable ... liaison between the SNF and the HMO Managed Care Insurance Companies. This includes all types of communication (eFax,...2 years of experience within the HMO Managed Care Insurance Companies + Knowledge of Medicare and Medicaid Managed… more
- Rochester Regional Health (Rochester, NY)
- …patient documentation, + Responsible for the timely completion and submission of insurance authorization request and denial appeals . + Conducts quality audits ... of patient records and processes + Provides initial and ongoing assessment for clients in order to determine diagnosis and appropriate level of care. + Provides individual, family and group counseling, which engages and motivates clients throughout treatment.… more
- University of Rochester (Rochester, NY)
- …Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500183 Health Insurance Counseling Work Shift: UR - Day (United States of America) Range: UR ... for shaping the quality, productivity, and efficiency of the Health Insurance and Authorization teams and identifying ongoing opportunities for process improvements… more
- CVS Health (Albany, NY)
- …**Quality Appeal Coordinator** coordinates reviews and evaluations for complaints and appeals received by the organization. This includes denied claims, coverage ... and independently coaches others on matters regarding complaints and appeals . **In this role, you will:** + Handle quality...experience working with claims. + Prior experience in health insurance . + Prior experience in compliance or auditing. +… more
- New York State Civil Service (Albany, NY)
- …of this position will be responsible for conducting hearings arising from appeals of eligibility determinations for health insurance and financial assistance. ... State NY Zip Code 12211 Duties Description The NYSOH Appeals Unit is a unit of Hearing Officers who...will have experience working as counsel for public health insurance programs and/or with a legal services organization specializing… more
- Staffing Solutions Organization (Albany, NY)
- …the new eligibility system for New York's Complex Medicaid population, and the new appeals management system. The individual will act as a liaison between the DEMI ... + Interpret guidance and instructions related to Medicaid eligibility, enrollment, appeals processes, and notices from a requirements perspective; perform analysis… more
- Mohawk Valley Health System (Utica, NY)
- …palliative care, end-of-life-care and hospice. + Apply knowledge of Health Insurance and Managed Care Programs, along with values- based care, pay-for-performance ... throughout the medical staff. + Assist case managers with Medicare and Medicaid appeals and Administrative Law Judge (ALJ) testimonies. Act as a liaison with payers… more