- Catholic Health (Buffalo, NY)
- …8-4 with varied hours based on role of management and oversight of team Summary: The Clinical Denials and Appeals , Clinical Supervisor is responsible for ... include setting up arbitration between parties. This individual provides clinical oversight to the clinical denials... areas and third-party payers in scenarios related to denials and appeals . This position educates all… more
- UHS (Binghamton, NY)
- Position OverviewUnited Health Services (UHS) is seeking a proactive and analytical Clinical Denials Specialist to join our Revenue Cycle team. In this vital ... role, you will focus on the prevention and resolution of clinical claim denials by analyzing denial patterns, investigating and appealing denied claims, and… more
- Catholic Health Services (Melville, NY)
- …Island's Top Workplace! Job Details Position Summary: The Utilization and Appeals Coordinator will perform activities to help facilitate utilization management and ... appeals functions to include coordination of specific process and...accurate utilization data in a timely fashion. + Monitors denials as well as all financial metrics associated with… more
- CenterWell (Albany, NY)
- …of our caring community and help us put health first** The Grievances & Appeals Representative 3 manages client denials and concerns by conducting a ... clinical and other Humana parties. The Grievances & Appeals Representative 3 performs advanced administrative/operational/customer support duties that require… more
- Garnet Health (Middletown, NY)
- …responsible for the day to day operation of the CDI department and DRG Denials appeals process. The Manager will develop, implement and evaluate processes, ... to make your career home with us as a CLinical Documnetaion Specialist on our CDI team at/in Garnet... Documentation Improvement and Patient Access, the Manager of Clinical Documentation Integrity (CDI) and DRG Denials … more
- Mount Sinai Health System (New York, NY)
- … Clinical /Technical/Service** + Demonstrates the ability to perform clinical /technical/service/administrative tasks: + Prioritizes Insurance Requests / Denials ... + Requests or provides Medical Records as required for appeals , On / Off-site Insurance reviews + Implements...Appeals Nurse / Manager by confirming status of denials + Tracking status of Medical Record requests for… more
- Mount Sinai Health System (New York, NY)
- …AR trends and billing lags. + Collaborate with department such as coding, IT, clinical service areas and appeals to ensure seamless end-to-end revenue cycle ... days in Accounts Receivable, increasing cash collections, reducing bad debt decreasing denials and eliminating write offs due to process issues. + Ensures workflows… more
- Mohawk Valley Health System (Utica, NY)
- …potential barriers to patient discharge. The Physician Advisor (PA) conducts clinical review of cases to ensure compliance with regulatory requirements, hospitals ... utilization of resources. The Physician Advisor guides the team to improve clinical and financial outcomes with documentation and clinical education. Core… more
- Bassett Healthcare (Cooperstown, NY)
- …reporting of resources and financial indicators including LOS, excess days, resource utilization, denials and appeals , swing bed statistics. + Uses data to drive ... facilitating patient care, with the underlying objective of enhancing the quality of clinical outcomes and patient satisfaction while managing the cost of care and… more
- Mount Sinai Health System (New York, NY)
- …facilitates and tracks concurrent adverse determinations and collaborates with Appeals Management Department in managing retrospective denials . ... Case Management FT Days** This position is responsible for coordinating requests for clinical information from third party payers and providing support to a broad… more