- Mount Sinai Health System (New York, NY)
- …financial performance based on analytical findings. + Support investigation into claims patterns, payor mix evaluation, and other strategic analytics to optimize ... Sinai Health System is one of the largest academic medical systems in the New York metro area, with...safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by… more
- University of Rochester (Rochester, NY)
- …review codes created by electronic charge capture and/or assigns codes through medical record documentation as per designated workflow. Completes system edit reviews ... to make corrections before transmittal. + Troubleshoots problems that prevent claims from being released. Identifies cause of edit and independently resolves issue… more
- Mount Sinai Health System (New York, NY)
- …ideal candidate will have had some experience working with health administrative/insurance claims data and other large datasets. Prior experience with the Department ... Sinai Health System is one of the largest academic medical systems in the New York metro area, with...safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by… more
- BronxCare Health System (Bronx, NY)
- …collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement ... and Customer Service. - Reviews and denials notification letters along with the medical records and all pertinent documentation related to the episode of care being… more
- Philips (Latham, NY)
- …Clinical Science team, the Senior MRI Clinical Scientist will collaborate with medical doctors and physicists of large academic hospitals (most notably University of ... Texas Southwestern Medical Center) with a focus on research, development, and...IP for product development and generate evidence to support claims through scientific publications. + Be hands-on, be able… more
- The Estee Lauder Companies (New York, NY)
- …accuracy, and alignment. - Partner with Legal to ensure viability of all claims wording, including regional variants. - On owned projects, partner with Art Directors ... status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity or gender expression (including transgender status),… more
- Humana (Albany, NY)
- …skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management ... receives guidance where needed. Follows established guidelines/procedures. + Complete medical record reviews for Behavioral Health Inpatient and Outpatient Provider… more
- Molina Healthcare (Buffalo, NY)
- …and Medicare/MMP. + Analysis and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality department ... retrospective HEDIS rate tracking and supplemental data impact reporting. + Develop Medical Record Review project reporting to track progress and team productivity… more
- MVP Health Care (Schenectady, NY)
- …in a calm and diplomatic manner. + Familiarity with healthcare benefits and/or medical terminology. + Excellent computer experience including MS Excel, MS Word. + ... every interaction **Your key responsibilities:** + 1-2 years relevant insurance, medical or healthcare experience + Experience with Facets **Your key… more
- MVP Health Care (Tarrytown, NY)
- …customers in every interaction **Your key responsibilities:** + Receive and review medical documentation for completeness; conduct outreach to medical offices ... responsibilities, familial status, physical or mental disability, handicapping condition, medical condition, pregnancy status, predisposing genetic characteristics or information,… more