- Rochester Regional Health (Rochester, NY)
- …budget. Ensures compliance to fiscal standards with focus on volume, payer mix, fees, customer service initiatives, productivity, coding, non-provider labor, ... including experience, relevant qualifications, specialty, internal equity, location, and contracts . Rochester Regional Health is an Equal Opportunity Employer. All… more
- Catholic Health Services (Melville, NY)
- …staff and other health team members to understand and help comply with payer / contract issues and appeal preparation. + Maintains strict standards for patient ... named Long Island's Top Workplace! Job Details The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and appeals according to industry… more
- Mohawk Valley Health System (Utica, NY)
- …of care. + Reviews high-cost medication charges and validates accuracy of billing against payer rules and contract terms. + Monitors daily drug charge edits, ... Pharmacy Revenue Cycle Specialist - Full Time - Days Department: 340B CONTRACT PHARMACY Job Summary The Pharmacy Revenue Cycle Specialist supports comprehensive… more
- Centene Corporation (New York, NY)
- …management activities to ensure compliance with current state, federal, and third-party payer regulators + Provides education to members and their families on ... Professional (eg, LCSW, LMSW, LMFT, LMHC, LPC) or RN based on state contract requirements with BH experience required Pay Range: $73,800.00 - $132,700.00 per year… more
- Rochester Regional Health (Rochester, NY)
- …Revenue Cycle + Review and scan insurance cards, checking for precertification and payer requirements. + Collect full financial information: payer name, ID and ... insurance eligibility via appropriate websites. + Complete the Medicare Secondary Payer Questionnaire for eligible patients. + Complete all required Medicare… more
- Albany Medical Center (Albany, NY)
- …- required + Computer skills (High proficiency) + Insurance knowledge regarding payer contract interpretation including Authorization Requirements and Setting of ... be able to work in conjunction with Nursing Supervision and Patient Triage Manager for accurate bed assignment for inpatient and observation patients. In addition,… more
- Saratoga Hospital (Saratoga Springs, NY)
- …calls to individuals and collecting payment in full or arranging payment contracts . You will initiate and follow up on Financial Assistance Applications preparing ... Ensures all necessary documentation is obtained prior to submitting application to Manager for approval. Generates approval/denial letters, as well as a Financial… more
- Catholic Health (Buffalo, NY)
- …This individual provides clinical oversight to the clinical denials team, ensuring payer contracts are being appropriately followed by all parties, denials ... and outpatient medical necessity. The individual also works to maintain third-party payer relationships. This includes, but is not limited to, responding to… more
- University of Rochester (Rochester, NY)
- …compliance with State and Federal Regulations, accreditation standards and third-party payer requirements for the purpose of minimizing risk and exposure. This ... business, market growth, service development and payor/PBM strategies. + Participates with payer contracting leaders of the health system in the evaluation and… more
- Rochester Regional Health (Rochester, NY)
- JOB TITLE: RN Case Manager STATUS: FT LOCATION: NW Monroe County DEPARTMENT: Home Care SCHEDULE: Days SUMMARY The RN Case Manager is responsible for the delivery ... changes in response to changing patient needs. The RN Case Manager identifies appropriate interdisciplinary services needed, coordinates those services and… more
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