- Highland Hospital (Rochester, NY)
- …via telemedicine dependent on clinical availability, personal preference, and insurance guidelines for telemedicine coverage 10-20%Office Practice (Non-Face to Face ... Time) + Assist office nursing and secretarial staff in phone management and triage of patients. +...Complete clinical documentation, forms/paperwork requested by patients, prior authorization appeals , sign home care orders + Coordinate with other… more
- BronxCare Health System (Bronx, NY)
- …arrive in letter and electronic format. Collaborating with the Department Denial and Appeals Coordinators, Physician Advisors, and the clinical staff , the Appeal ... Overview The Appeals Manager is responsible to assist in the...patterns and trends to prepare education programs for the staff on identified deficiencies to best respond to all… more
- Mount Sinai Health System (New York, NY)
- …the pre appeals department and related vendors , including supervision of pre appeals nurses, and support staff . + Develop and implement pre appeals ... **Job Description** **Director Pre Appeals Management-HSO Appeals Management -Corporate 42nd...while controlling costs. The Director collaborates closely with medical staff , vendors, case management, and payers to secure payment… 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...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
- Humana (Albany, NY)
- …The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D & B). The Medical director work assignments involve moderately ... and medical necessity. The Medical Director will collaborate with clinicians and support staff to provide Humana members with optimal value based care in accordance… more
- Elevance Health (East Syracuse, NY)
- **Audit & Reimbursement II- Appeals ** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... Perform cost report reopenings. + Under guided supervision, participate in completing appeals related work: + Position papers + Jurisdictional Reviews + Maintaining… 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
- NYU Rory Meyers College of Nursing (New York, NY)
- …posted and expected reimbursement for Article 28, Managed Care, Commercial Insurance and other payers. Analyze, audit and recover outstanding receivables. Identify ... the revenue cycle processes. Directly manage and resolve all assigned underpayment appeals , follow-up and payer relationships. Report to management any gross payment… 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 ... Support education to minimize clinical variability throughout the medical staff . + Assist case managers with Medicare and Medicaid.... + Assist case managers with Medicare and Medicaid appeals and Administrative Law Judge (ALJ) testimonies. Act as… more
