- Constructive Partnerships Unlimited (Manhattan, NY)
- …receiving services within the Manhattan residential programs receive appropriate and timely medical care in accordance with the regulations of the New York State ... of nursing services, as well as the performance and collaboration of medical doctors, consultants, and other healthcare professionals. 5. Conduct clinical care… more
- Evolent (Albany, NY)
- …are performed within the RN/LVN/LPN scope of practice, under Medical Director direction, using independent nursing judgement and decision-making, physician-developed ... medical policies, and clinical decision-making criteria sets. Acts as...+ Participates in continuing education initiatives. + Collaborates with Claims , Quality Management and Provider Relations Departments as requested.… more
- Elevance Health (Middletown, NY)
- …make an impact:** + Managing incoming calls or incoming post services claims work. + Determines contract and benefit eligibility; provides authorization for ... provide an equivalent background. **Preferred Skills, Capabilities and Qualifications:** + Medical terminology training and experience in medical or insurance… more
- Actalent (Scarsdale, NY)
- …video, creating plans for their return to work, and addressing further medical needs. Additionally, the Telehealth Nurse will develop infection control plans, ... collaborate with HR on return-to-work guidelines and workers' compensation claims . Responsibilities + Triage employees over the phone or...phone or video and create action plans based on medical concerns. + Clear employees to return to work.… more
- Walgreens (Wading River, NY)
- …generics, less expensive medicines, and over-the-counter products. Refers to the medical provider, as needed, to ensure medication is taken correctly, health ... technology. Finds opportunities to improve productivity + Ensures insurance claims are processed accurately to prevent payment rejections. Resolves patient… more
- Walgreens (East Elmhurst, NY)
- …privacy, generics, less expensive medicines, over-the-counter products, and refers to medical provider as needed to ensure medication is taken correctly, health ... to further promote productivity. + Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment rejections. Follows-up with… more
- Cardinal Health (Albany, NY)
- …Health's At-Home Solutions ("AHS") business clients, a leading home healthcare medical supplies provider serving people with chronic and serious health conditions ... AHS business unit is comprised of four complementary business units: (1) Edgepark Medical Supplies, a leading mail order supply company that specialize in serving… more
- Constructive Partnerships Unlimited (Queens, NY)
- …outcomes. Identifies individual's development strengths and health care needs. Obtains emergency medical care when necessary. + Develops and updates health care plan ... to address assessed needs. Provides direct medical /nursing services to assigned individuals as presented. + Oversees the implementation of the health care plan by… more
- Air National Guard Units (Westhampton Beach, NY)
- …separated units (GSU(s), and tenant units, with responsibility for managing all medical administrative functions including medical support, medical ... present oral and written recommendations concerning physicals, drug testing and medical material. Must have experience with pertinent laws, regulations, policies and… more
- Highmark Health (Albany, NY)
- …related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, ... steps to effect resolution. (10%) + Reviews and interprets medical information, classifies that information into the appropriate payor...skills Preferred + Associate's Degree + 3 years with claims processing and data management + Past auditing and… more