- Centene Corporation (New York, NY)
- …of all appeals requests + Partners with interdepartmental teams to improve clinical appeals processes and procedures to prevent recurrences based on industry ... York State clinical license.** **Position Purpose:** Performs clinical reviews needed to resolve and process appeals...analyzing the basis for the appeal + Ensures timely review , processing, and response to appeal in accordance with… more
- Glens Falls Hospital (Glens Falls, NY)
- …including charge discrepancies, CCI edits, and charge review * Serve as a clinical resource for appeals and denials * Review /update of Charge Master ... this role is for you! *Team Impact* As the Clinical Nurse Manager, you will provide overall clinical...of care in the event of staff absence * Review patient surveys and feedback and creates action plans… more