- Evolent (Albany, NY)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional ... endovascular procedures, implantable cardiac devices, etc) that do not initially meet medical necessity guidelines or require further evaluation by a subject matter… more
- WMCHealth (Valhalla, NY)
- …addressing appeals to insurance companies and coding highly complex medical records using the current International Classification of Diseases (ICD10 CM/PCS ... role is expected. Does related work as required. Responsibilities: + Addresses appeals to insurance denials to facilitate expedient resolution and reimbursement. +… more
- University of Rochester (Rochester, NY)
- …GENERAL PURPOSE Serves as the patient referral and prior authorization specialist , with oversight of data and compliance to enterprise standards and ... company barriers and tracking all assistance provided. Accountable for planning, execution, appeals and efficient follow through on all aspects of the process which… more
- Garnet Health (Middletown, NY)
- …CLinical Documnetaion Specialist on our CDI team at/in Garnet Health Medical Center. Responsibilities Under the direction of The Administrator, Coding & Clinical ... day operation of the CDI department and DRG Denials appeals process. The Manager will develop, implement and evaluate...department. The Manager ensures that reviews of the patient's medical data are conducted to assess appropriateness and … more
- Rochester Regional Health (Rochester, NY)
- …- 4:30PMSUMMARY Participates and supports oversight of office processes of the Medical Management Department to maintain daily operations. Oversees the daily review ... of Third Party Payors are maintained. + Participates and supports the medical management department in the tracking, trending and reporting of appeals… more
- Cardinal Health (Albany, NY)
- …skills and prioritizes getting the right things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will ... system. + Manages and resolves complex insurance claims, including appeals and denials, to ensure timely and accurate reimbursement....benefits and programs to support health and well-being. + Medical , dental and vision coverage + Paid time off… more