- Rochester Regional Health (Rochester, NY)
- …coordination of testing to be performed with physician, patient, facility and payer . This includes reviewing medical documents for clarity, ensuring all necessary ... clinical steps have been taken; works with necessary parties to obtain third-party approval. + Obtains all procedure and diagnosis codes to properly authorize/pre-certify ordered testing. + Refers self-pay and out-of-network patients to the appropriate… more
- Arnot Health (Elmira, NY)
- …conjunction with the patient/family, other members of the health care team, the payer , and available resources, formulates a plan to address assessed needs and ... issues, implements the plan, evaluates the effectiveness of the plan in meeting established care goals and revises the plan as needed to reflect the changing needs, issues and goal. ** 8. Evaluates the effects of Case Management on target populations. ** 9.… more
- Norstella (Albany, NY)
- …+ Strong attention to detail + Expert knowledge of provider and payer dynamics within healthcare, specifically within oncology, cellular therapy / CAR-T, immunology, ... neurology / CNS, and/or other rare diseases / specialty therapeutics **The Guiding Principles For Success At Norstella** **01: Bold, Passionate, Mission-First** We have a lofty mission to Smooth Access to Life Saving Therapies and we will get there by being… more
- Guthrie (Corning, NY)
- …nursing practice. Preferred experience with care management/utilization review, and payer knowledge. Fast paced ambulatory care experience preferred. Education: ... Bachelor's degree in nursing or related field required. With an employment agreement, will consider applicant who is actively pursuing their bachelor's degree. Master's Degree preferred. Licenses: The Care Coordinator-Transitional Care nurse must be licensed… more
- Catholic Health Services (Melville, NY)
- …Identifies opportunities for capturing additional revenue in accordance with payer guidelines. Develops specifications to modify existing charge capture applications ... to reduce charge-related claim edits/rejections. Coordinates and assists with research and implementation of charge capture processes for new services and/or new/updated technology. Works with Coding and clinical departments to identify/resolve errors based on… more
- Stony Brook University (East Setauket, NY)
- …and New York Medicaid reimbursement methodologies. + Knowledge of third-party payer reimbursement and managed care contracts. + Experience in utilizing insurance ... websites to check for eligibility and claim status. + Experience investigating, reviewing and following-up on rejected/denied inpatient and outpatient hospital claims. + Knowledge of CPT, HCPCs and ICD-10 coding principles. + Experience with Cerner Invision… more
- UHS (Vestal, NY)
- …detail, excellent communication skills, and the ability to navigate complex payer requirements. Every connection you make-from clarifying benefits to securing ... approvals-helps patients move forward with the therapy they need. Primary Department, Division, or Unit: UHS Physical Therapy and Rehabilitation Vestal Primary Work Shift: Day Regular Scheduled Weekly Hours: 40 Compensation Range: $17.98 - $25.17 per hour,… more
- Mount Sinai Health System (New York, NY)
- …The Patient Encounter Associate performs all support functions related to patient reception, scheduling and financial pre-clearance, ensuring a high degree of patient ... satisfaction and maximum reimbursement to the institution. Responsibilities include but are not limited to: scheduling, pre-registration, self-pay screening and insurance eligibility determination. Responsible for obtaining and verifying patient demographic… more
- Saratoga Hospital (Saratoga Springs, NY)
- …outreach. + Manage daily work using multiple systems and applications-EMR systems, payer portals, vendor platforms, Microsoft 365 for Excel, Word and PowerPoint, ... Microsoft Outlook and Teams for messaging and meetings. + Work with patient lists, gap lists, sourced health data and medical records in your daily work. + Leverage all quality-related resources to ensure the accuracy and completeness of work-measure/project… more
- BGB Group (New York, NY)
- …of services, including traditional pharmaceutical advertising, promotional medical education, payer marketing, and consulting services. Known for excellence and ... professionalism, we're hired as strategic and creative partners by our biopharmaceutical clients to drive category/brand awareness and growth. Position Overview: The Senior Copywriter is responsible for combining important supervisory and executional… more