- CenterLight Health System (NY)
- …highest levels of quality. + Participates in all quality assurance and regulatory compliance activities to ensure appropriate regulatory certifications. + ... any other clinical documentation. + Participate in all quality assurance and regulatory compliance activities to ensure appropriate regulatory certifications. +… more
- Lincoln Financial (Albany, NY)
- …on the new product implementation across functions. *Support the annual assumption review process , including assumption development and implementation in life ... projects. The team plays a critical role in ensuring model accuracy, regulatory compliance, and alignment with company strategy. This position will also provide… more
- Bassett Healthcare (Hamilton, NY)
- …of life possible. What you'll do The Referral Coordinator coordinates the referral process for patients in the regional health centers from scheduling to receipt of ... liaison between primary care physicians, specialty physicians and patients. Review and verify insurances that require pre-authorizations and monitor timeline… more
- Stony Brook University (Stony Brook, NY)
- …Revenue Cycle Management is responsible for the development, implementation, maintenance, review and audit of the Hospital Charge Description Master to optimize ... audits utilizing both software tools and/or EMR and documentation review . May assist in the resolution of pre-billing charging...complete a 4 panel drug screen * + Meet Regulatory Requirements for pre employment screenings. + Provide a… more
- WMCHealth (Valhalla, NY)
- …medical review guidelines and parameters to assure consistency in the review process to reflect appropriate utilization and compliance with various ... cases when clinical determinations cannot be made by initial clinical review . + Discusses determinations with requesting physicians or ordering providers when… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …Management (CM) and Registered Nurse (RN) reviewers and manages the denial process . + Leads interdisciplinary complex care management rounds. + Provision of clinical ... and PH care across the UM/ CM staff. + Participates in clinical peer review recruitment and supervision. + Collaborates with Provider Relations staff to ensure an… more
- Molina Healthcare (Albany, NY)
- …requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the denial process . + Monitors appropriate care ... a working knowledge of applicable national, state, and local laws and regulatory requirements affecting the medical and clinical staff. MD licenses required for… more
- Wells Fargo (New York, NY)
- …focused on service continuity, incident response, and release governance, while meeting regulatory and client expectations. + **Conduct Performance Review Forums ... : Lead regular management-level sessions with business line partners to review application stability metrics and operational trends. Use data-driven insights to… more
- Tompkins Community Bank (Ithaca, NY)
- …Trust Officers with all aspects of new account opening, investment and account review process , marketing and client support. Provide exceptional service to ... follows policies and procedures to ensure compliance with Company and regulatory requirements. Responsibilities + Perform Customer Service related tasks including… more
- Mastercard (Harrison, NY)
- …to launch stage and beyond of various solutions and services. * Structure, draft, review , and negotiate a wide range of contracts with various partners in the open ... and contractual matters. *Collaborate with product and legal teams (including regulatory , compliance, and data privacy) to advise holistically on product constructs… more