- CDPHP (Latham, NY)
- …on nationally recognized criteria and CDPHP policies, and procedures. QUALIFICATIONS: + Registered Nurse with a current New York State license required. ... to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the...years of acute care experience is required as a Registered Nurse . + Minimum of two (2)… more
- Lincoln Financial (Albany, NY)
- …**What we're looking for** Education * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state where ... organization. This position will be responsible for reviewing, analyzing, and interpreting medical information available for disability claims . In this role you… more
- Constructive Partnerships Unlimited (Brooklyn, NY)
- …the Residence Manager, and reports all medical issues/ injuries to the registered nurse and follows protocols for notification. 13. Performs variety of ... reports and maintaining database of consumer health information after review and signed by the RN . +...+ Performs all other duties as assigned by the registered nurse . II. POSITION REQUIREMENTS A. Qualifications… more
- Constructive Partnerships Unlimited (Brooklyn, NY)
- …medical issues with VP of Nursing, Nurse Administrator, Registered Nurse ( RN ), and Medical Coordinators2. Maintains medical records, including ... health recordse. As directed by the VP of Nursing/ Nurse Administrator debrides hard copy of medical ...stationery supplies.23. Perform data entry tasks accurately and efficiently. Review data for deficiencies or errors.24. Assist with special… more
- BronxCare Health System (Bronx, NY)
- …Licensed Practical Nurse : Under the direct supervision of a physician and/ or Registered Nurse , participates in the application of the nursing process to an ... (according to the NPSG), intake screening of patient, pre-visit planning (if applicable), review of medical record to determine visit requirements such as HEIDS… more
- UHS (Binghamton, NY)
- …(5) years of experience in acute/tertiary facility. + Minimum Required: NYS Licensed Registered Nurse Preferred: + Bachelor's of Science in Nursing with three ... vital role, you will focus on the prevention and resolution of clinical claim denials by analyzing denial patterns, investigating and appealing denied claims ,… more
- Elevance Health (Latham, NY)
- …enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . + Responsible for independently ... Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Investigator Senior** is responsible for the independent… more
- Catholic Health (Buffalo, NY)
- …finance, business management, operational analysis, information systems or related field + Registered Nurse with a four (4) year degree and Unrestricted ... for the people, carrying out and documenting the appeals process for denied claims denied due to reasons including, but not limited to clinical documentation/support… more
- Arnot Health (Elmira, NY)
- …Auth/Denial Management meetings EDUCATION: RN required. EXPERIENCE: NYS licensed Registered Nurse required. Bachelor's in nursing preferred. Must have ... Case Managers! MAIN FUNCTION: The Case Management (denial/prior auth) will review and appeal as appropriate for concurrent and retrospective authorization and… more
- Independent Health (Buffalo, NY)
- …exceptional customer service to all internal and external customers. **Qualifications** + Registered Nurse ( RN ) with active, current, unrestricted NYS ... Two (2) years of case management or clinical experience in acute medical /surgical/critical care or ambulatory setting required. + Proficient computer and Windows… more