- Cognizant (Albany, NY)
- …+ Experience in the analysis and processing of claims for payments, utilization review /quality assurance procedures. + Excellent problem-solving skill in ... with stakeholders and other teams. **Primary Responsibilities** : + Review claim system data and verify against UB or...UB or HCFA paper or EDI information. + Evaluate medical records to determine if the service rendered was… more
- Humana (Albany, NY)
- …focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with health ... part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims. The Corporate… more
- Fresenius Medical Center (Bayside, NY)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. ... a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in...+ Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. +… more
- Cherry Bekaert (Albany, NY)
- …Resource Coordinator will effectively fill resource engagement requests overseeing the utilization of resources, ensuring alignment of resources with the strategic ... Serve as a trusted business advisor for service leads. + Generate scheduling, utilization and forecasting reports and provide analysis of the data that assists… more
- Project Renewal, Inc. (New York, NY)
- …in the development and implementation of quality assurance management and utilization review + Participates in interdisciplinary meetings with shelter ... Manhattan, and Brooklyn Hours: Monday, Thursday, and Friday 9-5 Reports to: Medical Director, Primary Care Salary: $111,000 to $120,000 depending on experience… more
- UHS (Johnson City, NY)
- Position OverviewUnited Health Services is seeking a Director of Nursing - Medical Surgical Services to lead strategic and daily operations across medical ... helps ensure exceptional patient experiences and sustainable operational success across the Medical Surgical Services area. Work Locations: UHS Wilson Medical … more
- Mount Sinai Health System (New York, NY)
- …a patients condition that falls within their specialty area of practice. NOTE: Medical orders, progress notes and treatments plans are not required to be ... Documents findings and plan of care in the patient's medical record. + Consults with physician according to established...the plan of care. + Performs a patient record review with the collaborating physician in a timely fashion… more
- Cognizant (Albany, NY)
- …guidelines and regulations + Experience in the analysis and processing of claims, utilization review /quality assurance procedures + Must be able to work with ... Based** Claims Processors to join our growing team. The ** Medical ** **Claims Processor** is responsible for the timely and...HCFA paper, or EDI information. + Responsible for reviewing medical records when necessary to determine if the service… more
- Fresenius Medical Center (Jamaica, NY)
- …communicated to and implemented by the facility staff. + Maintains integrity of medical records and other FMS administrative and operational records. + Complies with ... as pertinent. **STAFF:** + Responsible for implementation of FMS staffing, and medical supply models, to provide quality patient care, and makes recommendations. +… more
- Rochester Regional Health (Rochester, NY)
- … necessity in the Care Management Data base to support the clinical review process. + Concurrently monitors resources utilization , performing continued stay ... in the expected time frame and with most efficient utilization of resources. Carries out activities related to ...continuum. + Appropriately identifies and refers cases to the Review Physician Advisor to validate level of care based… more