- Highmark Health (Albany, NY)
- …and retrospective claims review basis. Review process includes a review of medical documentation, itemized bills, and claims data to assure appropriate ... and the proper action to complete the retrospective claim review with the goal of proper and timely payment...criteria, as well as other approved guidelines, payment and medical policies.Promote quality and efficiency in the delivery of… more
- New York State Civil Service (New Windsor, NY)
- …proper documentation.* Administer medications and treatments.* Order medications and medical supplies.* Review and transcribe physician's orders.* Complete ... semi-annual nursing summary and attend reviews.* File medical reports, ensure follow-up and tracking of ... medical reports, ensure follow-up and tracking of medical appointments, and maintain medical record. *… more
- ConnectLife (Williamsville, NY)
- …family, and others as necessary. 12. Participate in Hospital Development activity and Medical Record Review as necessary. 13. Remain proactive to stay informed ... 4. Follow the donor management guidelines approved by the ConnectLife Medical Director to maximize donor potential. If needed, engage physicians, practitioners,… more
- University of Rochester (Rochester, NY)
- …medical suitability for organ and/or tissue donation through laboratory studies, medical record review and physical assessment. + Completes authorization form ... (DRAI) once willingness to donate is identified. + Provides appropriate medical information regarding potential donor's organ function to personnel at designated… more
- Premier Medical Group of the Hudson Valley (Poughkeepsie, NY)
- …practice and regulatory standards. * Participate in quality improvement initiatives, peer review , and continuing medical education. * Promote patient education, ... Endocrinology Classification: Exempt, Full-Time Reports to: CEO About Premier Medical Group: Premier Medical Group of the...to: CEO About Premier Medical Group: Premier Medical Group of the Hudson Valley is a multi-specialty… more
- CDPHP (Latham, NY)
- …of prescription and medical benefits as it applies to the utilization review process. + Must demonstrate proficient experience with the Microsoft Office suite. + ... Must be conscientious, efficient and accurate in prior authorization, exception and medical /Rx necessity review processing. + Continually strive to develop… more
- LaSante Health Center (Brooklyn, NY)
- …patient encounters accurately. + Research data for reimbursement needs. + Analyze medical records for documentation deficiencies. + Review documentation to ... Medical Coder LaSante Health Center is seeking a detail-oriented in-person Medical Coder to ensure accurate coding and abstraction of patient encounters. The… more
- Molina Healthcare (Syracuse, NY)
- …data. * 5+ Years of experience in Analysis related to HEDIS rate tracking, Medical Record Review tracking, Interventions tracking for at least one line of ... analysts on software applications, business domain and design standards. *Conducts peer review of other analysts (internal and contract staff) to ensure standards… more
- Albany Medical Center (Albany, NY)
- …documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation improvement and contacts ... to achieve continuous improvement in both areas.* Refers cases and issues to Medical Director and Triad Team in compliance with Department procedures and follows up… more
- SUNY Upstate Medical University (Syracuse, NY)
- …contracts with reimbursement entities. This is achieved through a thorough chart review and utilization of first-level screening criteria to ensure patients are at ... hospital stay. The UR-CR 1 will collaborate with the medical team and the UR medical directors...clinical conceptual understanding for purposes of level of care review . Strong communication skills, both written and verbal, as… more