- Mount Sinai Health System (New York, NY)
- …+ Current New York State license as a Registered Professional Nurse or other licensed/certified clinical professional strongly preferred; foreign healthcare ... 9. Interfaces with the HRA/TDC on-site investigators reporting potential claims as well as cases of concern by preparation...Sinai Health System is one of the largest academic medical systems in the New York metro area, with… 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 ... k) Reports changes in patient's conditions to the Registered Nurse . l) Prepares patient for examination and assists provider...or damaged equipment promptly * Checks alarm settings on medical devices and ensures they are audible. * Checks… more
- Highmark Health (Buffalo, NY)
- …gain/risk share contract parameters. This includes analysis and interpretation of claims submission for superior coding accuracy, cost and utilization reports, ... medical loss ratio reports, Medicare STARS gaps and other...strategies to meet market needs **LICENSES/CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + None **Language (Other than English):** None… more
- Arnot Health (Elmira, NY)
- …discourage preventable denials DUTIES AND RESPONSIBILITIES: 1. Retrospectively determines medical necessity and appropriateness of admission and stay in accordance ... information to appropriate billing clerks and management. 6. Follow up on denial claims using reports to ensure completion of appeal with other department staff 7.… more
- GE Vernova (Schenectady, NY)
- …of 110%, 120% or 130% of salary in certain areas. Healthcare benefits include medical , dental, vision, and prescription drug coverage; access to a Health Coach, a ... 24/7 nurse -based resource; and access to the Employee Assistance Program,...Protection (PIP), foreign trade zones, bonded warehouses, duty recovery claims , etc. + Support of import and export permits… more
- Trinity Health (Albany, NY)
- …is strongly preferred). Master's degree preferred. Certification (CPHRM) is preferred. Registered Nurse preferred. Ideally, the candidate will have 3-5 years in risk ... standing and walking. **WORK CONTACT GROUP:** All services, employees, medical staff, patients, visitors, vendors, various regulatory and professional agencies.… more
- Rochester Regional Health (Rochester, NY)
- …Patient Safety, Patient Relations, Security, Finance, Regulatory, Compliance, Ethics, Claims /Insurance, and Legal) to integrate risk management principles into daily ... related field required. + For those with a BSN; valid NYS Registered Nurse License is required. + Certification in quality improvement, safety, clinical risk… more