- Trinity Health (Troy, NY)
- …for Utilization Management and works collaboratively with Utilization Management/Concurrent Review Nurse, physicians, staff and other health care professionals. ... Interacts with internal and external providers to review and monitor members' utilization of health care services with the goal of maintaining high-quality… more
- City of New York (New York, NY)
- …with subpoenas and court orders served upon the Agency. - Assist with the review and processing of Freedom of Information Act requests. - Assist in the conduct ... regarding legal compliance of CODIS and LDIS DNA Database. - Draft, review , and edit Non-Disclosure Agreements, Data Sharing Agreements, and Beta Testing pertaining… more
- UMB Bank (New York, NY)
- …Compliance team supports the Corporate Trust group by performing account review , monitoring and ensuring compliance with regulations, and producing account summaries ... Compliance Specialist II role is responsible for the initial review of every piece of new business closed by...and therefore each specialist works independently to meet individual review goals. However the team meets regularly as a… more
- CenterLight Health System (Ridgewood, NY)
- …onboarding and reassessment, UAS-NY completion, comprehensive assessment, medication review , and post-hospital discharge evaluation. The Clinical Assessment Manager ... questions or concerns during the assessment to the quality review team to ensure appropriate completion of UAS-NY and...home visits. + Utilizes Lenavi analyzer during either the review process and/or assessment. + Documents all interactions and… more
- Travelers Insurance Company (Albany, NY)
- …which can impact claim outcomes. Organize and coordinate Travelers' medical review functions. This includes interpreting Federal and State regulations and medical ... guidelines to establish medical review policies. Works in close collaboration with the Claim...as appropriate. Train and evaluate physician and non-physician medical review personnel and activities. + Stay apprised of changes… more
- MTA (New York, NY)
- …and its Subsidiary Agencies to deliver an effective and efficient Internal Control Review program that roots out fraud, waste, and abuse. Additionally, this role ... with the MTA Inspector General on compliance matters. + Assist in the review , update, and development of MTA and its subsidiary agencies' policies for relevance… more
- Trinity Health (Albany, NY)
- …Practice Management to identify educational opportunities as necessary. + Responsible for review of denial/ rejections and write off dashboards for trends and ... "Clean Claims" + Works within the working queue to review all charges and submit to claims scrubber +...timely basis + Identify any problematic charges for further review to correct coding/billing issues + Adhere to productivity/quality… more
- Molina Healthcare (Syracuse, NY)
- …at a health plan or vendor-is strongly preferred. **Knowledge/Skills/Abilities** + Review Medicaid COB claims for correct secondary pricing logic and compliance ... as needed. + Utilizes SQL to pull data for review and distribution. + Accurately interprets end to end...automated configuration processes/solutions + Assist manager in establishing peer review standards and methodology + Research and review… more
- Bassett Healthcare (Cooperstown, NY)
- …timely and accurately during downtime procedures, as measured by random supervisory review of order processing. Maintains the patient's medical record according to ... unit and organizational standards, as evidenced by supervisory chart review . Updates patient clinical information systems in a timely manner in order to assure… more
- Stony Brook University (Commack, NY)
- …+ Responsible for running daily DNFB reports and distributing to Senior Staff + Review multiple and various daily reports for any add on payment information and ... or for a maximum of 90 days. An initial review of all applicants will occur two weeks from...full consideration, applications must be received before the initial review date (which is within two weeks of the… more