- Sedgwick (Albany, NY)
- …and physician filings and decisions on appropriate treatments recommended by utilization review . + Maintains professional client relationships. **ADDITIONAL ... claim files are properly documented and claims coding is correct. + May process complex lifetime medical and/or defined period medical claims which include state… more
- UHS (Johnson City, NY)
- …Primary Department, Division, or Unit: Cardiac Catheterization Lab, UHS Wilson Medical Center Primary Work Shift: Day Rotational Regular Scheduled Weekly Hours: ... and the delivery of health care services. + RESOURCE UTILIZATION : Evaluates and administers the resources of nursing services....Comprehensive Benefits for Life & Family - We offer medical , dental, and vision coverage starting the first of… more
- Humana (Albany, NY)
- …medical terminology and/or ICD-10 codes. + Member service + Experience with Utilization Review and/or Prior Authorization, preferably within a managed care ... orders and arrange a safe facility discharge. + Work with UM Nurses, Pharmacy, Medical Directors and other Departments. + During downtime make calls to UM Nurses,… more
- Cognizant (Albany, NY)
- …experience. * Experience in the analysis and processing of claims for payments, utilization review /quality assurance procedures. * Must be able to work with ... UB or HCFA paper or EDI information. * Responsible for reviewing medical records when necessary to determine if service rendered was medically appropriate… more
- Catholic Health Services (Freeport, NY)
- …you are seeking. We offer career advancement, a rich tuition reimbursement program, medical benefits, a generous pension plan, 403B for retirement and PTO plan. Join ... team to provide caseload assignment and general oversight of electronic medical record in addition to providing counseling, intervention, and continuity of… more
- City of New York (New York, NY)
- …utility. Conduct routine data transfers and quality assurance on interview and medical record data. Regularly review data collection and management functions ... further spread of HIV. In addition, the HIV program Medical Monitoring Project (MMP) is an HIV surveillance system...goal of guiding HIV prevention, preventive behaviors, and service utilization . The HIV Epidemiology program is looking a CRS… more
- CVS Health (Farmingdale, NY)
- …your understanding of patient safety and error prevention, quality assurance drug utilization review (DUR), pharmacy professional standards such as corresponding ... care by solving or escalating patient problems + Offering to counsel, fielding medical questions, and soliciting information on a patient's medical history to… more
- Bassett Healthcare (Cooperstown, NY)
- …communication of cost-effective medication use issues in collaboration with the medical staff, pharmaceutical care services staff, and/or any other appropriate staff ... Contributes to the advancement of the profession through peer review for professional journals, publications and presentations at local,...efficacy to the patient population at hand. Good computer utilization and ability to adapt to a variety of… more
- WM (Syracuse, NY)
- …our founding over 30 years ago, we have grown from a small start-up in medical waste management into a leader across a range of increasingly complex and highly ... comfortable providing accurate service feedback o Conduct customer visits to review serviceo Manage customer interaction records to resolve service issueso Monitor… more
- Canon USA & Affiliates (Albany, NY)
- …the customer and CMSU. + Provide clinical advice to customers to improve utilization of the system and ancillary equipment to help improve their clinical outcomes. ... dinners as requested. + Additional assignments as needed, for example, competitive review . + Represent CMSU as the clinical expert at customer sales meetings… more