- Health Plus Management LLC (Uniondale, NY)
- Denial Management Associate Location Uniondale Description Health Plus Management (HPM) is a Physician Support Organization and market leader in clinical ... service and patient care).This position is primarily responsible for overseeing the Denial Management functions for our family of companies.Duties &… more
- Health Plus Management LLC (Uniondale, NY)
- …School Diploma or equivalent required, 2+ years of experience with A&R, or Denial Management across multiple insurance carriers and specialties Knowledge & ... + 2+ years of experience with No-Fault & Workers Compensation AR/Collection and Denial Management across multiple insurance carriers and specialties + Must have… more
- Health Plus Management LLC (Uniondale, NY)
- …Diploma or equivalent required + 2+ years of experience with A&R & Denial Management across multiple insurance carriers and specialties Knowledge & Experience ... Associate - No Fault Location Uniondale Description Health Plus Management LLC (HPM) provides management services to...years of experience with NYS Workers' Compensation AR and Denial Management Benefits Medical, Dental, Vision, and… more
- BronxCare Health System (Bronx, NY)
- … Manager will assist the department's leadership develop strategies for denial prevention, improved utilization management , documentation of medical necessity ... and other resources, escalates issues related to business associate interactions and department staff when prevented from completing...On the job or formal training in certified case management , denial and appeals management … more
- Rochester Regional Health (Rochester, NY)
- …Therapist provides addiction diagnostic assessment, treatment planning, case management , and individual/group counseling for clients with chemical dependency. ... and residential settings, the Addiction Therapist is also responsible for oversight and management of the patient community. Treatment is provided in the context of… more
- Highmark Health (Buffalo, NY)
- …the incumbent informs the member and/or provider of the approval and/or denial of the requested authorization. **ESSENTIAL RESPONSIBILITIES** + Obtain call task from ... Utilization Management platform, perform verbal outbound call task requirement following...within the platform. + Obtain triage task from Utilization Management platform and follow a detailed desk level procedure… more
- OLV Human Services (Lackawanna, NY)
- …+ Comfort using computers (NextGen experience a plus) + High school diploma required; Associate 's degree preferred Why You'll Love It Here: + Make a positive impact ... courteous attitude in all communications. - Operating computer using dental practice management software, internet and other vendor related programs. - Maintain a… more
- Nuvance Health (Poughkeepsie, NY)
- …of the Director, The Nurse Case Manager role provide clinically-based case management to support the delivery of effective and efficient patient care. Paces ... physiological and economic perspectives. Has overall accountability for the utilization management and transition management for patients within the assigned… more
- University of Rochester (Rochester, NY)
- …in EPIC + Works in assigned EPIC follow up workqueue(s). + Review reason for claim denial - reason code or denial codes in EPIC. + View Payer Website link ... and clarify billing issues, payment variances and/or trends that require management intervention; share with Supervisor and/or Manager. Assist Supervisor with credit… more
- Northwell Health (Manhasset, NY)
- …budgetary variances; ensures front-end operations are followed (ie co-pay collection, denial management , insurance verification, missing charges, and other key ... diversified administrative responsibilities in the areas of Business Operations, Financial Management , Human Resource Management , Information Management ,… more
- Mount Sinai Health System (New York, NY)
- …+ In-depth knowledge of the coding process, coding systems software, workflow management , and excellent navigation of electronic medical records + Experience and ... improvement. + Review accounts in various WQs to identify coding errors, denial patterns and troubleshoot root causes, if/when needed. + Assist with reviewing… more
- Zurich NA (New York, NY)
- …129143 Zurich is currently looking for a Legal Claims Professional for our growing Management Solutions group. If you are ready for a career move, consider working ... settlement negotiations + Draft reservation of rights and coverage denial letters + Notify Underwriter of claim issues +...skills + Ability to multi-task + Organization and time management skills + Ability to work independently + Experience… more
- University of Rochester (Rochester, NY)
- …prepares a response to the payer with necessary additional information. + If the denial management needs to involve other clinic staff or providers, the required ... equity considerations._ **Responsibilities:** GENERAL PURPOSE Responsible for the overall management of drug access for high-cost specialty and restricted access… more
- University of Rochester (Albany, NY)
- …The Claims Resolution Representative III reports to Accounts Receivable Management . **ESSENTIAL FUNCTIONS:** With general direction of the Manager/Supervisor/Lead: + ... and grievances to the insurance companies. + 10% Keeps management informed of changes in billing requirements and rejection...informed of changes in billing requirements and rejection or denial codes as they pertain to claim processing and… more
- University of Rochester (Rochester, NY)
- …Follows up on unpaid accounts working claims. Reviews reasons for claim denial . Reviews payer website or contacts payer representatives to determine why claims ... clarifies billing issues, payment variances, and/or trends that require management intervention. Assists department leadership with credit balances account… more
- Highmark Health (Albany, NY)
- …to prescribing physician and impacted member. + Populate all authorization and denial information fields within the OnBase information system. + Enter all ... + Experience in pharmacy prescription claims processing/submission/payment. **Preferred** + Associate degree + Pharmacy technician certification certificate + Experience… more
- M&T Bank (Getzville, NY)
- …payment histories. + Work closely with other teams within Customer Asset Management (CAM), Collections, Loss Mitigation, SPOC and component servicing team to ensure ... proper approval or denial before activating the foreclosure process and customer and...and ability to work independently. **Education and Experience Preferred:** Associate 's degree in Accounting or Business. Knowledge of M&T… more
- City of New York (New York, NY)
- …license categories, and drafting DCWP contracts and agreements. Reporting to the Associate General Counsel, the Staff Counsel will: - Conduct legal research related ... at the NYC Office of Administrative Trials and Hearings (OATH), and/or draft denial or revocation letters for applicants or licensees in certain license categories.… more
- University of Rochester (Rochester, NY)
- …+ Follows up on unpaid accounts working claims. + Reviews reasons for claim denial . + Reviews payer website or contacts payer representatives to determine why claims ... and clarifies billing issues, payment variances, and/or trends that require management intervention. + Assists department leadership with credit balances account… more
- Ellis Medicine (Schenectady, NY)
- …EXPERIENCE REQUIREMENTS: + Education: High School Diploma or Equivalent required. Associate 's degree preferred. + Experience: 2 years of accounts receivable ... deposit slips. + Review Billing Exception Report for Revenue Management , the Medicare system (FISS), and the claims scrubber...refunded to the payer within 30 days. + Each denial will be reviewed for appropriateness and will be… more