- Northwell Health (Melville, NY)
- …and the third party payer. Prepares and defends level of care and medical necessity for assigned case. Collaborates with physician advisor, payor representative ... regulations. Performs concurrent and retrospective utilization management using evidenced-based medical necessity criteria; conducts clinical reviews and formulates appeal… more
- Saratoga Hospital (Saratoga Springs, NY)
- Denials Assistant - Patient Financial Services Location: Saratoga Hospital, 59D Myrtle Street Park, Saratoga Springs, NY 12866 Employment Type: Full Time ... people. About the Role We're looking for a dedicated Denials Assistant to join our team and help us...entering data into the EMR system, assisting in compiling appeals and reconsiderations. + Collaborate and communicate effectively with… more
- Humana (Albany, NY)
- …a part of our caring community and help us put health first** The Grievances & Appeals Representative 3 manages client denials and concerns by conducting a ... with clinical and other Humana parties. The Grievances & Appeals Representative 3 performs advanced administrative/operational/customer support duties… more
- Cardinal Health (Albany, NY)
- …in the appropriate system. + Manages and resolves complex insurance claims, including appeals and denials , to ensure timely and accurate reimbursement. + ... Processes denials & rejections for re-submission (billing) in accordance with...benefits and programs to support health and well-being. + Medical , dental and vision coverage + Paid time off… more
- Rochester Regional Health (Rochester, NY)
- Job Title: Business Office Representative Department: Location: Hours Per Week: Schedule: Sign-On Bonus: SUMMARY: Ensure full reimbursement is received by RRH for ... sent to primary and secondary insurances. Research and resolve denials and payer requests for information promptly and accurately...phone calls to the payer. Submit corrected claims and appeals . + Process account adjustments and refunds as needed… more
- Garnet Health (Middletown, NY)
- …a must, with knowledge in Revenue/CPT Code descriptions and the ability to write appeals for denials is required. Should know the statutes and CMS regulations ... we invite to make your career home with us as a Patient Accounting Representative on our Patient Financial Services team at/in Garnet Health Medical … more
- The Institute for Family Health (New Paltz, NY)
- …philosophy, standards, objectives and policies of the Department and the Organization. The representative shall have a basic understanding of medical billing and ... Explanation of Benefits for designated accounts and posts payments and denials accurately upon receipt. + Provides clerical support to senior representatives… more
- University of Rochester (Albany, NY)
- …internal equity considerations._ **Responsibilities:** GENERAL PURPOSE The Claims Resolution Representative III is responsible for working across the professional ... and routine action to resolve unpaid claims. The Claims Resolution Representative III reports to Accounts Receivable Management. **ESSENTIAL FUNCTIONS** With general… more
- WMCHealth (Suffern, NY)
- …to the hospital to ensure patient has coverage, services provided are covered, denials and appeals minimized and payments are expedited. + Reviews registration ... information from the patient while activating the patient encounter for medical treatment. Utilizes the various systems, assesses each account related concern… more