- Independent Health (Buffalo, NY)
- …statistics. + Perform validation of diagnosis and procedure coding by reviewing medical record documentation and/or provider claims data. Ensure coding ... + Responsible for all reconsideration clinical appeals to include review of records, consultation with Medical Director,...to include review of records, consultation with Medical Director, response to facilities as well as coordination… more
- Mount Sinai Health System (New York, NY)
- …Conducts Root Cause Analysis investigations, which includes assessing need for focused review by departments, and or clinical chairpersons for peer reviews. 5. ... to the reported incident (s). 7. Facilitates the peer review process and completion of safety solutions. 8. Identifies...9. Interfaces with the HRA/TDC on-site investigators reporting potential claims as well as cases of concern by preparation… more
- Deloitte (Rochester, NY)
- …and business terms) with PBMS + Experience performing analytical analysis of medical & pharmacy claims , including understanding financial impact of network ... emerging trends and cost drivers + Work directly with medical and PBM vendors to analyze the program offering...+ Implement competitive vendor search and selection initiatives + Review of health plan renewals including assisting in rate… more
- Tompkins Community Bank (Batavia, NY)
- …the billing procedure for account transactions + Provide assistance to customers reporting claims + Review and maintain current ImageRight "To Do List" + ... procedures + Process all in-coming and out-going mail + Review Insurance company communications daily + Review ...office equipment + AMS experience is desirable Benefits + Medical + Dental + Vision + 401(k) Match +… more
- C&W Services (New York, NY)
- …support for all EH&S activities, including implementation, monitoring, and review of C&W compliance/performance. **Job Description** ESSENTIAL FUNCTIONS AND ... all logs and documentation associated with permits and regulatory requirements * Review accidents and incidents which occur in the area of responsibility and… more
- Colliers Engineering & Design (Syracuse, NY)
- …to scheduling, logistics, sequencing, cost, quality, and progress as well as negotiating claims and change orders. + Review and evaluate project related ... schedules, contracts, and proposals for services prepared by others, as well as review construction documents on a regular basis for conformance to project goals,… more
- City of New York (New York, NY)
- …sick leave usages, OSHA's WCS report, City Counsel Report of Workers' Compensation Claims , separations payout for staff, Family Medical Leaves, etc. for assigned ... using CityTime for assigned departments. The individual must also review and correct errors resulting from previously processed system...does not receive and Commissioner's Check. - Process and review of Manual Leave (MLA) and Employee Time Report… more
- Arnot Health (Elmira, NY)
- …Case Managers! MAIN FUNCTION: The Case Management (denial/prior auth) will review and appeal as appropriate for concurrent and retrospective authorization and ... discourage preventable denials DUTIES AND RESPONSIBILITIES: 1. Retrospectively determines medical necessity and appropriateness of admission and stay in accordance… more
- Bowman (Albany, NY)
- …by more senior staff to ensure application of sound techniques and principles. Review work produced by junior staff for quality assurance. **At the Operational and ... of values, various exhibits, partial and final liens. + Review , process, obtain approvals, code and accrue for subconsultant...that may arise as it relates to disputes, or claims + Act as liaison between operations and many… more
- Cardinal Health (Albany, NY)
- …laws including, Antitrust; healthcare laws and regulations, (eg, Anti-Kickback, False Claims Act, and HIPAA); and Marketing and Advertising + Demonstrate excellent ... business teams, including sales, marketing, operations and finance + Review marketing materials related to customer services and FDA...benefits and programs to support health and well-being. + Medical , dental and vision coverage + Paid time off… more