• Clinical Appeals Specialist

    CDPHP (Albany, NY)
    …share these values and invites you to be a part of that experience. The Clinical Appeals Specialist is responsible for adhering to a member/provider appeal ... Using knowledge of clinical nursing and medical practices, the Clinical Appeals Specialist will review medical necessity requests, render determinations… more
    CDPHP (07/27/24)
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  • Registered Nurse - Specialist Denials…

    St. Mary's Healthcare (Amsterdam, NY)
    …based on experience and other factors permitted by law. Responsibilities: * Uses clinical and coding knowledge to ensure accurate and compliant charge items and to ... and audit requests and coordinates attempts to overturn denials by drafting appeals , negotiating with payers, or following up with payer utilization review… more
    St. Mary's Healthcare (07/23/24)
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  • Area Business Specialist , Immunology…

    J&J Family of Companies (Albany, NY)
    Area Business Specialist , Immunology (Albany, NY) Johnson and Johnson Innovative Medicine, Inc. - 2406206573W **Description** Johnson & Johnson Innovative Medicine, ... Inc. is recruiting for an Area Business Specialist , Immunology for the Albany NY At Johnson & Johnson, we believe health is everything. Our strength in healthcare… more
    J&J Family of Companies (08/27/24)
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  • Claims Coding Specialist

    Whitney Young Health Center (Watervliet, NY)
    Claims Coding Specialist (Req 100825) Watervliet, NY (http://maps.google.com/maps?q=1601+Broadway+Watervliet+NY+USA+12189) Apply Description GENERAL ... function; reviews the work of other medical coding and clinical staff to ensure compliance with departmental policies and...accordance with contracts, calling payers on open claims, sending appeals on denied claims and following up on requests… more
    Whitney Young Health Center (08/10/24)
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