- BronxCare Health System (Bronx, NY)
- …claims and audits of registration/insurance verification activities to improve denial rates and enhance revenue. In-service staff on Insurance ... participates in the Performance/Quality Improvement activities of the assigned department . Contribution and participation includes data collection, analysis, implementation… more
- WMCHealth (Hawthorne, NY)
- … Specialist is responsible for providing analysis and reporting for all Denial Management functions at Westchester Medical Center Health Network. The role ... Denials Specialist Company: NorthEast Provider Solutions Inc. City/State: Hawthorne,...measures + Ensures that all activities related to Denials Management functions meet department requirements, maximizes revenue… more
- Mount Sinai Health System (New York, NY)
- …8a-1p with Every Weekend** To maintain front end operations of the Case Management Department by monitoring all incoming correspondence and ensuring it reaches ... **Job Description** **Insurance Specialist MSH PT Days 4/Days Week (Days Vary)...of the philosophy, standards, objectives and policies of the Department and the Hospital Center. **Qualifications** + Applicable work… more
- Mount Sinai Health System (New York, NY)
- …processes appeals. Posts denials in IDX on a timely basis. + Provides comprehensive denial management to facilitate cash flow. Tracks, quantifies and reports on ... resolution to ensure accurate and timely payment of claims and collection. The Specialist works directly with the Department Administrator. Reports to Billing… more
- Hackensack Meridian Health (Hackensack, NJ)
- …Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of clinical records ... not limited to utilization review, hospital reimbursement, clinical compliance, case management , and transitions of care, as outlined in the responsibilities below.… more
- City of New York (New York, NY)
- …is responsible for the organization, direction and supervision of the Case Management , Case Establishment, and the Case Support units which facilitate eligibility ... (FIA) is recruiting for one (1) Administrative Job Opportunity Specialist NM I, to function as Benefit Access Center...ensuring that Agency's requirements are met for opening, reopening, denial , closing, change in case status and change in… more
- Molina Healthcare (Yonkers, NY)
- …on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + Identifies and reports quality ... a formal appeals request has been made or upon request by another Molina department to reduce the likelihood of a formal appeal being submitted. + Independently… more
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