- The Arc Erie County NY (Williamsville, NY)
- …the Office for People With Developmental Disabilities OPWDD, Medicaid, Medicare , insurance companies, municipalities, Department of Health, school districts, and ... direct supervision from the Coordinator of Physical and Occupational Therapy, Associate Director of Related Services and/or Associate Director of Clinical… more
- Callen-Lorde Community Health Center (New York, NY)
- …workflows, scheduling, billing, and patient access. Reporting directly to the Director of Dentistry, the Manager of Dental Operations will supervise dental ... cost-effectiveness. + Support budgeting, forecasting, and cost-control strategies with the Director of Dentistry. Patient Experience & Access + Develop and implement… more
- CenterWell (Westbury, NY)
- …audits/billing are completed timely and in compliance with Medicare regulations. + Coordinates communication between team members/attending physicians/caregivers ... of care and outcome planning. + Works in conjunction with the Branch Director and Company Finance Department to establish location's revenue and budget goals. +… more
- Catholic Health Services (Smithtown, NY)
- …+ Licensed by the New York State Department of Health + Certified by the Medicare and Medicaid Program + Operated by a New York State Licensed Nursing Home ... Administrator DUTIES: + Coordinates with the Medical Director , Attending Physicians, Nursing Staff, Rehabilitation Staff and Ancillary Support Staff in providing the… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …set by regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review. Refer to and work closely with Case Management to address ... and refers potential quality of care and utilization issues to Medical Director . + Utilizes appropriate communication techniques with members and providers to obtain… more
- New York State Civil Service (Schenectady, NY)
- …in the Electronic Health Record, to be sent to the medical director /designee for review and approval. * Conduct clinical review of discipline-specific treatment ... that meet the regulatory driven content criterion to the medical director /designee for final authorization. * Ensure written service recommendations are distributed… more
- Mount Sinai Health System (Brooklyn, NY)
- …10. Answering phones and responding to urgent requests. Escalating concerns to Director . Follow-up to ensure issues have been resolved. 11. Performs appropriate ... Notification Record, Insurance Authorization Financial Agreement, and Important Message from Medicare about Discharge, NYS Caregivers Act. 21. Functions as a liaison… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …set by regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review. Refer to and work closely with Case Management to address ... and refers potential quality of care and utilization issues to Medical Director . + Utilizes appropriate communication techniques with members and providers to obtain… more
- Arnot Health (Elmira, NY)
- …receive the maximum reimbursement that is allowable. 9. Demonstrates knowledge of Medicare requirements for approved ICD-9 codes and to communicate to the provider ... when a code is not approved, and knowledge of Medicare waivers. 10. Demonstrates the ability to accurately pre-authorize / pre-certify patients exams for all… more
- Cognizant (Albany, NY)
- …. Draft and submit the medical necessity determinations to the Health Plan/Medical Director based on the review of clinical documentation in accordance with ... Medicare , Medicaid, and third-party guidelines. . Effectively document and...can be based on InterQual, Milliman Clinical Guidelines (MCG), Medicare guidelines, and health insurer specific guidelines. . Review… more