- Kaleida Health (Buffalo, NY)
- …as facilitating strong working relationships between HIM, Clinical Documentation, UR, Physician Advisor operations, PFS, Contracting, and hospital departments ... where diversity is valued and celebrated!_ **Position** Director Clinical and DRG Denials **Location** US:NY:Buffalo | Management | Full-Time **Req ID** null… more
- Catholic Health Services (Melville, NY)
- …and presents to Physician Advisors during the monthly Physician Advisor meeting. + Attends hospital Utilization Management (UM) committees. + Supervises ... with management in recruiting new Catholic Health Physician Advisor hires. + Trains new ...criteria for all levels of care). + Experience with denials management . + Knowledge of clinical, quality,… more
- Mohawk Valley Health System (Utica, NY)
- PHYSICIAN ADVISOR Department: CASE MANAGEMENT Job Summary The Physician Advisor collaborates with Care Managers and Attending Physicians to align on ... of care, patient billing status, and potential barriers to patient discharge. The Physician Advisor (PA) conducts clinical review of cases to ensure compliance… more
- Arnot Health (Elmira, NY)
- …Maintains a working relationship with Physician Advisor regarding physician issues related to auths/ denials . 9. Provide insurance companies with ... $10,000 Sign on Bonus for qualified Case Managers! MAIN FUNCTION: The Case Management (denial/prior auth) will review and appeal as appropriate for concurrent and… more
- Nuvance Health (Rhinebeck, NY)
- …medical information from insurers and other sources to the case managers and physician advisor . * Obtains Medicaid & Managed Medicaid Authorization for patient ... *Description* Summary: Coordinates inpatient denials for the hospital with emphasis on data...denials for the hospital with emphasis on data management and reporting. Coordinates and manages all Utilization Review… more
- Catholic Health Services (Melville, NY)
- …Manage Care Payors or regulatory agencies, as needed or requested. + Manages physician advisor reports and assists with facilitating UM Committee reviews when ... hospitals, three nursing homes, a home health service, hospice and a network of physician practices across the island. At Catholic Health, our primary focus is the… more
- Rochester Regional Health (Rochester, NY)
- …patients across the continuum. + Appropriately identifies and refers cases to the Review Physician Advisor to validate level of care based on medical necessity ... Job Title: Care Facilitator Department: Case Management Location: Canton-Potsdam Hospital with floating to other...plan of care. + Performs retrospective reviews on insurance denials and assists in appeal process. + Participates in… more
- Catholic Health Services (Roslyn, NY)
- …skills to ensure timely resolution of issues. + Refers cases and issues to Physician Advisor in compliance with identified procedures and follow-up as indicated. ... Overview Director-Care Management Are you exceedingly driven, dedicated, and passionate...denials . + Serves as a resource to physicians, physician advisors, CM department, and hospital staff. + Collaborates… more
- Nuvance Health (Poughkeepsie, NY)
- …and at a minimum the case manager reviews observation cases daily. 3. Utilizes physician advisor to interface with physicians as needed. 4. Collaborates with the ... to prevent the denial where possible. 5. Supports the effective prevention and management of denials , including providing information as part of the appeal… more