- GAF (Parsippany, NJ)
- …And under this roof, we protect what matters most. **SUMMARY** Management of the Claims Evaluation Lab. Manage the overall Claims Evaluation process for all ... as a primary objective, development and maintenance of standardized claims evaluation protocols, claims analysis and reporting...towns. The TPO helps protect what is under that hospital 's roof. In addition to quality products, we make… more
- The Mount Sinai Health System (New York, NY)
- **JOB DESCRIPTION** **Accounting Clerk (Commercial Claims Follow-up) Full-Time M-F 9AM to 5PM East 42nd Street** Under the supervision of the Patient Financial ... Supervisor/ Manager , performs a variety of patient accounting functions, including...from Mainframe System to Clearing House. Transmits all clean claims daily to Clearing House and other direct payers.… more
- The Mount Sinai Health System (New York, NY)
- …and address facility managed care contracts with regard to language, pricing, claims submission and appeals, claims adjudication and coverage policies, as ... providers /Departments on new and impactful payer coverage and claims payment policies. Work with Communications on large scale...E01 - Partner MSO Services - MSH, Mount Sinai Hospital **REQUIRED SKILLS** MS Excel MS Word **ABOUT US**… more
- The Mount Sinai Health System (New York, NY)
- …science. Advancing medicine. Healing made personal. **Job Title: Senior Clinical Risk Manager - Mount Sinai West** **Job Summary:** The Senior Clinical Risk ... Manager serves as a resource to staff to enhance...with the HRA/TDC on-site Professional Liability Investigators: reporting potential claims as well as cases of concern by preparation… more
- The Mount Sinai Health System (New York, NY)
- **JOB DESCRIPTION** The Clinical Risk Manager reports to the Director of Risk Management and Patient Safety and is responsible for reviewing, summarizing, analyzing, ... presenting and monitoring safety events, claims management, loss prevention and reduction, patient safety related...the Mount Sinai Health System (MSHS)., The Clinical Risk Manager conducts investigations and prepares reports as required by… more
- The Mount Sinai Health System (New York, NY)
- **JOB DESCRIPTION** The Clinical Risk Manager in the Department of Risk Management and Patient Safety is responsible for the day to day risk management activities ... of Health and conducting risk management educational programs. The Clinical Risk Manager is responsible for the coordination and investigation of serious adverse… more
- Elevance Health (New York, NY)
- **Anticipated End Date:** 2024-09-16 **Position Title:** RN Hospital Bill Audit/Appeal Lead **Job Description:** **RN Hospital Bill Audit/Appeal Lead** ... to recover, eliminate and prevent unnecessary medical-expense spending. The **RN Hospital Audit/Appeal Lead** is responsible for leading a team of clinicians… more
- VNS Health (Manhattan, NY)
- …and proofs provider directories. + Assists providers in triaging billing and claims disputes. + Participates and collaborates with Compliance on Department of Health ... and internal audits. + Participates in special projects and performs other duties as assigned. Qualifications Licenses and Certifications: + Driver's license, required Education: + Bachelor's Degree or equivalent work experience in a health care setting,… more
- The Mount Sinai Health System (New York, NY)
- …financed through third party payors. These activities include the consolidation of hospital and physician fees from both full-time and voluntary faculty. This ... and non-cash payments to distributes them accordingly to the hospital and professional networks accounts. **RESPONSIBILITIES** 1.Collaborates with all stakeholders… more
- Hackensack Meridian Health (Hackensack, NJ)
- …for physician services. **Responsibilities** A day in the life of a ** Manager , Hospital Billing - Physician Billing** at **Hackensack Meridian** **_Health_** ... in a healthcare business setting. + Minimum of three years of Hospital /facility/Professional claims experience working in an automated environment. + Excellent… more
- The Mount Sinai Health System (New York, NY)
- **JOB DESCRIPTION** The Utilization Review Manager for the Selikoff Centers for Occupational Health is responsible for the management of program operations within a ... and external regulatory and survey requirements. + The Utilization Review Manager collaborates with multiple professionals to support and coordinate the… more
- The Mount Sinai Health System (New York, NY)
- …- our goal is to keep entire communities healthy and out of the hospital . The Ambulatory Pharmacy is the team driving this transformation within Mount Sinai. The ... have an effective and seamlessly connected healthcare experience. The Program Manager supports department or program leadership and manages the activities and… more
- The Mount Sinai Health System (New York, NY)
- **JOB DESCRIPTION** Senior Clinical Risk Manager The Senior Clinical Risk Manager serves as a resource to staff to enhance patient safety, promote patient ... protect the assets of the facility. The Senior Risk Manager supports the Risk Management staff on how best...with the HRA/TDC on-site Professional Liability Investigators: reporting potential claims as well as cases of concern by preparation… more
- The Mount Sinai Health System (New York, NY)
- …1. Analyzes data requests using information technology, enrollment, claims , pharmacy, clinical, contract, medical management, financial, administrative and ... care EMR such as Epic/Clarity, aCW, etc.; a payor claims system such as Facets, Amisys, etc.; or a... system such as Facets, Amisys, etc.; or a hospital /provider system such as IDX, Soarian, etc. + Knowledge… more
- Walgreens (New York, NY)
- …others accountable for efficient workflow. + At the direction of the Pharmacy Manager or pharmacist, prepares, and files reports and records required by the company ... maintenance of pharmacy department equipment. In collaboration with Pharmacy Manager , responsible for recordkeeping and ensuring security safeguards are in-place.… more
- The Mount Sinai Health System (New York, NY)
- **JOB DESCRIPTION** The Outpatient Pharmacy Clinical Manager is responsible for performing and excelling in leadership, clinical and administrative duties. As a ... * Determine payer coverage and whether medical or pharmacy claims are required for medications. * Initiate and conduct...Practice experience required + 6 or more years of hospital clinical experience + NYS Pharmacist licensure Non-Bargaining Unit,… more
- Northwell Health (Manhasset, NY)
- …standardization, measurements, and performance improvement initiatives/activities within hospital . Job Responsibility + Provides leadership to Quality ... Device Act; acts as a resource person and educate hospital personnel regarding risk management related medical, legal and...from different sources, including (but not limited to) past claims , incident reports, and patient complaints. + Ensures the… more
- The Mount Sinai Health System (Astoria, NY)
- **JOB DESCRIPTION** The Clinical Risk Manager in the Department of Risk Management is responsible for the day to day risk management activities at Mount Sinai Queens ... of Health; and conducting risk management educational programs. The Clinical Risk Manager is responsible for the coordination and investigation of serious adverse… more
- ZOLL Medical Corporation (Garden City, NY)
- …as our portfolio of cardiac diagnostic services to Health Care Professionals in the hospital and out of hospital setting. This includes the initial sales call ... intake and reimbursement to ensure appropriate and timely filing of billing claims + Maintain credentialing/access to all assigned accounts at all times… more
- The Mount Sinai Health System (New York, NY)
- **JOB DESCRIPTION** The Senior CBO Revenue Cycle Manager reporting to the Senior Director of CBO Operations, is responsible for directing and coordinating the ... meetings with department staff and providers to provide information/feedback on claims /denials to ensure optimal AR management. Analyzes Department metrics to assess… more