- Evolent (Albany, NY)
- …outcomes. **Collaboration Opportunities:** + Routinely interacts with leadership and management staff , other Physicians, and staff whenever a physician`s input ... expert. + Provides clinical rationale for standard and expedited appeals . + Discusses determinations (peer to peer phone calls)...+ Ensures documentation of all communications with medical office staff and/or MD provider is recorded in a timely… more
- Mount Sinai Health System (New York, NY)
- …with appropriate corrections and documentation. + Works declines and processes appeals . + Ensures that established billing targets for collections, gross, days ... and corrects errors. + Reviews correspondence and rejection data from insurance carriers; posts rejections and performs reconciliations. + May transfer secondary… more
- Crouse Hospital (Syracuse, NY)
- …department, including Utilization Management, Discharge Planning and Denials and Appeals functions. + Assessing workflow related to readmission prevention, length ... and daily review of observation admissions. + Works with Business Office staff regarding workflow processes and maintains an effective denials management process. +… more
- Evolent (Albany, NY)
- …outcomes. **Collaboration Opportunities:** + Routinely interacts with leadership and management staff , other Physicians, and staff whenever a physician`s input ... of the request and provides clinical rationale for standard and expedited appeals . + Utilizes medical/clinical review guidelines and parameters to assure consistency… more
- Evolent (Albany, NY)
- …outcomes. **Collaboration Opportunities:** + Routinely interacts with leadership and management staff , other Physicians, and staff whenever a physician`s input ... of the request and provides clinical rationale for standard and expedited appeals . + Utilizes medical/clinical review guidelines and parameters to assure consistency… more
- University of Rochester (Rochester, NY)
- …follow-up to obtain maximum revenue collection. Researches, corrects, resubmits claims, submits appeals and takes timely and routine action to resolve unpaid claims. ... Resolves complex claims. Acts as a resource for lower-level staff . **ESSENTIAL FUNCTIONS** + Completes follow up activities on...research and resubmit rejected claims to obtain and verify insurance coverage. + Follows up on unpaid accounts working… more
- University of Rochester (Albany, NY)
- …follow-up to obtain maximum revenue collection. Researches, corrects, resubmits claims, submits appeals and takes timely and routine action to resolve unpaid claims. ... complex claims. Acts as a resource for lower level staff . **ESSENTIAL FUNCTIONS** + Completes follow up activities on...research and resubmit rejected claims to obtain and verify insurance coverage. Follows up on unpaid accounts working claims.… more
- Amgen (New York, NY)
- …the entire reimbursement journey through payer prior authorization to appeals /denials requirements and forms + Review patient-specific information in cases ... during the access process, including formulary coverage/utilization management criteria, insurance forms & procedures, benefits investigation, prior authorization, appeal,… more
- Lifespan (Rochester, NY)
- …opportunities of longer life. We are a great place to work where staff can grow personally and professionally in a supportive and inclusive environment. ... in the planning and execution of fundraising campaigns, donor appeals , and special events. + Generate reports and analyze...+ Help coordinate donor communications. + Collaborate with program staff to gather stories and data for donor engagement.… more
- University of Rochester (Rochester, NY)
- …assistants. May train and coordinate activities of peers or support staff . MACHINES AND EQUIPMENT USED: Standard office equipment including computer, calculator, ... and pends them for review and approval. - Anticipates needs of insurance companies by gathering all necessary information for referrals and prior authorizations.… more