- Evolent (Albany, NY)
- …Stay for the culture. **What You'll Be Doing:** Job Description 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...policies and procedures. + Documents communications with medical office staff and/or MD provider as required. + Interfaces with… 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
- Molina Healthcare (Albany, NY)
- **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical decisions for appeals outcomes within compliance ... standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases in which a formal appeals… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Senior CBO Appeals Analyst position requires an in-depth knowledge of healthcare pricing/reimbursement processes and procedures including ... This position is an internal subject matter expert supporting staff and clients and will need to respond to...collaboration with the Underpayment Team manager, the Senior CBO Appeals Analyst will work to further the CBO's goals… more
- 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 ... in Allscripts + Meets time frame for reviews / appeals as specified by Insurance / State...professional image. + Participates in the development of other staff members. + Meets regulatory, licensure and annual health… more
- Brooklyn Defender Services (Brooklyn, NY)
- …services, including for housing, public benefits, education, and employment. BDS staff work collaboratively and across disciplines to deliver high-quality legal ... frequent hearings and trials, often on an emergency basis. Staff attorneys are expected to provide high-quality and zealous...their case. + In collaboration with our law and appeals and paralegal teams, write motions, memos of law… more
- University of Rochester (Rochester, NY)
- …ALC reports are worked daily and are followed up appropriately. + Assist with third-party appeals at advanced levels escalated by staff . + Lead and evaluate task ... activities and control deadlines. + Disseminate expertise in health insurance products to supervisors and staff . + Provide coverage to Director, fellow… more
- Stony Brook University (Stony Brook, NY)
- …expedite required services. + Perform minor joint procedures. + Work with clinic staff together for insurance appeals and pre-authorizations as necessary. ... supervising physician. + Collaborate with supervising physician and nursing staff in the facilitation and interpretation of laboratory test...+ Coordination with clinic staff of patient care for both outpatients and inpatients… more
- University of Rochester (Rochester, NY)
- …ALC reports are worked daily and are followed up appropriately. + Assist with third-party appeals at advanced levels escalated by staff . + Lead and evaluate task ... activities and control deadlines. + Disseminate expertise in health insurance products to supervisors and staff . +...in health insurance products to supervisors and staff . + Provide coverage to Director, fellow department Managers… 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 ... may include but are not limited to: + Supervise staff . + Act as a liaison with the policy...Interpret guidance and instructions related to Medicaid eligibility, enrollment, appeals processes, and notices from a requirements perspective; perform… more