- Arnot Health (Elmira, NY)
- …information to appropriate billing clerks and management. 6. Follow up on denial claims using reports to ensure completion of appeal with other department staff 7. ... Management meetings EDUCATION: RN required. EXPERIENCE: NYS licensed Registered Nurse required. Bachelor's in nursing preferred. Must have proficient writing… more
- Molina Healthcare (Albany, NY)
- …focused reviews and recommends corrective actions. + Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. ... Chief Medical Officer. + Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review, and manages the denial… more
- GE Vernova (Schenectady, NY)
- …and prescription drug coverage; access to a Health Coach, a 24/7 nurse -based resource; and access to the Employee Assistance Program, providing 24/7 confidential ... & Partners in Protection (PIP), foreign trade zones, bonded warehouses, duty recovery claims , etc. + Support of import and export permits & licensing and other… more
- University of Rochester (Rochester, NY)
- …Under the direct supervision of the Practice Manager, Clinic Director and Nurse Manager works with considerable latitude for independent judgement. Responsible for ... routine and non-routine letters of correspondence related to appeals on denied claims , billing and patient communications. + This includes compiling all necessary… more
- Trinity Health (Albany, NY)
- …is strongly preferred). Master's degree preferred. Certification (CPHRM) is preferred. Registered Nurse preferred. Ideally, the candidate will have 3-5 years in risk ... Works with leadership to develop risk mitigation plans associated with litigated claims . Ensures that patient care-related incidents are reported to Trinity System… more
- ZOLL Medical Corporation (Bronx, NY)
- …include: Physicians (Cardiologists, Electrophysiologists, Hospitalists, CT Surgeons etc.), Nurse Practitioners, Physician Assistants, nurses, case managers and ... intake and reimbursement to ensure appropriate and timely filing of billing claims + Maintain credentialing/access to all assigned accounts at all times… more
- Mount Sinai Health System (New York, NY)
- …+ Current New York State license as a Registered Professional Nurse or other licensed/certified clinical professional strongly preferred; foreign healthcare ... reports etc. 9. Interfaces with the HRA/TDC on-site investigators reporting potential claims as well as cases of concern by preparation of preliminary reports,… more
- Rochester Regional Health (Rochester, NY)
- …Patient Safety, Patient Relations, Security, Finance, Regulatory, Compliance, Ethics, Claims /Insurance, and Legal) to integrate risk management principles into daily ... related field required. + For those with a BSN; valid NYS Registered Nurse License is required. + Certification in quality improvement, safety, clinical risk… more