-
Utilization Review Specialist
3 weeks ago
NavitsPartners New York, United StatesPosition: Utilization Review Specialist · Location: Brooklyn, NY 11235 · Duration: 13 weeks of contract (extendable) · Shift: 08 hrs/ day & 40 hrs./week ( 8:30 AM-4:30 PM) · Hourly pay: $65/hourly · Education: · Foreign Medical Graduate (FMG) · Bachelor's Degree · Skills: EMR · D ...
-
claims review specialist
1 week ago
City of New York New York, United States Full timeYOU MUST BE PERMANENT IN THE ELIGIBILITY SPECIALIST CIVIL SERVICE TITLTE OR IF YOU ARE HIRED PROVISIONALLY IN THE ELIGIBILITY SPECIALIST TITLE YOU MUST TAKE AND PASS THE ELIGIBILITY SPECIALIST CIVIL SERVICE EXAM WHEN IT BECOMES AVAILABLE TO BE ELIGIBLE FOR CONTINUED EMPLOYMENT. · ...
-
Document Review Specialist
1 week ago
Lenmar Consulting New York, United StatesTitle: Document Review Specialist · Location: NYC · Remote/Hybrid/Onsite: Hybrid · Position Type: Contract, possible temp-to-perm · Duration: 12+ months · Rate: $ $25.00/hr · Job ID: MOR2JP · Client: Morgan Stanley · Client facing position within Brokerage's Institutio ...
-
Institutional Review Board Specialist
5 days ago
NYU Langone Health New York, United States Full time/RegularWe have an exciting opportunity to join our team as a Institutional Review Board Specialist. · Reporting to the Senior Scientific Manager Full Board (SSM) of the IRB, the Specialist is responsible for the efficient pre-review of full board modification and continuation submission ...
-
Document Review Specialist
1 week ago
US Tech Solutions New York, United States: Client facing position within Brokerages Institutional Equity Division (IED) for a documentation specialist, responsible for handling all relationship level trading agreements, including, but not limited to equity derivatives, prime brokerage, stock loan, confidentiality, liste ...
-
Institutional Review Board Specialist
2 weeks ago
NYU Langone Health New York, United StatesNYU Grossman School of Medicine is one of the nation's top-ranked medical schools. For 175 years, NYU Grossman School of Medicine has trained thousands of physicians and scientists who have helped to shape the course of medical history and enrich the lives of countless people. An ...
-
Institutional Review Board Specialist
2 weeks ago
NYU Langone Health New York, United States**NYU Grossman School of Medicine** is one of the nation's top-ranked medical schools. For 175 years, NYU Grossman School of Medicine has trained thousands of physicians and scientists who have helped to shape the course of medical history and enrich the lives of countless people ...
-
Rewards Review Engagement Specialist
1 week ago
Doctors Without Borders | Médecins Sans Frontières New York, United States**Role Overview** · The Rewards Review aims to develop a new rewards framework for the whole MSF global workforce, enabling us to better meet operational needs. MSF's executive leadership (the Full ExCom) agreed on changes to create a rewards system that provides more equity, tra ...
-
TGA Site Manager"
2 weeks ago
SilverLinx Hudson, United StatesJoin our team at Hudson GA-tec Building and Plant Technology GmbH, a subsidiary of the Sodexo Group. We are one of the leading providers of technical building equipment and offer technical facility management services. With over 1200 employees and multiple locations throughout Ge ...
-
Environmental Scientist
3 weeks ago
TSR Consulting Services, Inc. Newark, United StatesLong term contract -Newark NJ · Environment Scientist · A large Utility Company is looking for Environment Scientist. A degree in geology, environmental science or related engineering discipline and a minimum of 3 to 5 years' experience with investigation and remediation of conta ...
-
Contracts Specialist
1 day ago
Insight Global New York, United StatesTitle: IT Contracts Specialist · Salary: $110K · Location: New York, NY (1 Park Ave) – 2x/week onsite (Wed/Thurs) · Duration: Perm · Must-Haves: · 5+ years of experience as a Contracts Specialist/Paralegal · Experience drafting large corporate documents (software licensing, profe ...
-
HR Document Specialist
2 weeks ago
Tandym Group New York, United StatesA New York City healthcare organization is looking to fill an immediate need with the addition of a new HR Documentation Specialist to their growing team. The HR Documentation Specialist will catalog documents so they can be accessed when needed, while ensuring only the appropria ...
-
senior crpu specialist
1 week ago
City of New York New York, United States Full timeYOU MUST BE PERMANENT IN THE JOB OPPORTUNITY SPECIALIST TITLE FOR AT · LEAST ONE YEAR. THIS IS A PROVISIONAL APPOINTMENT, WHEN A TEST · BECOMES AVAILABLE IN THE ASSOCIATE JOB OPPORTUNITY · SPECIALIST (AJOS) TITLE, YOU MUST TAKE AND PASS THE EXAM TO · REMAIN IN THE AJOS TITLE. ...
-
Insurance /Risk Specialist
1 day ago
Clark Davis Associates New York, United StatesInsurance /Risk Management Specialist position for a well-known co. in NYC. 1+ yrs. experience handling in-house and exterior claims , review COI, evaluate risks, and interact with carriers. Bachelors degree required. · ...
-
Demand Management Specialist
3 weeks ago
LHi Group New York, United StatesTop Tier FS Services Business -Demand Management Specialist Opportunity - IT Project Management Function · Lawrence Harvey is currently partnered with a a well-known financial services leader; they are rapidly growing and hiring a Demand Management Specialist. This person will si ...
-
Behavior Intervention Specialist
2 days ago
Tandym Group New York, United StatesA health services network in New York City is currently seeking a new Behavior Intervention Specialist to join their team in Brooklyn. In this role, the Behavior Intervention Specialist will be responsible for providing oversight of psychiatric medications and providing written r ...
-
Administrative Assistant 2
2 weeks ago
Attorney General, Office of the New York, United States Full timeMinimum Qualifications For Permanent Appointment: Reachable on the Department of Civil Service Eligible list for Administrative Assistant 2 (formerly Secretary 2) OR permanent or contingent permanent status as an Administrative Assistant 2 OR eligible to transfer. · For Provision ...
-
Investor Relations Associate
3 days ago
ELCO Consulting New York, United StatesCOMPANY DESCRIPTION: · Our client is a multi-billion dollar private credit investment management firm. · JOB DESCRIPTION: · Our client seeks a product specialist/senior associate to join the team and focus on the firm's direct lending products. · Responsibilities include: · Suppo ...
-
Payroll Specialist
1 day ago
Tandym Group New York, United StatesA healthcare network in New York City is looking to fill an immediate need at one of their Brooklyn facilities with the addition of a new Payroll Specialist. · About the Opportunity: · Start Date: ASAP · Department: Finance · Schedule: Monday to Friday · Hours: 9am to 5pm (35 hou ...
-
Senior Billing Specialist
5 days ago
Kay Search Group New York, United StatesPosition: Senior Billing Specialist (Global Law Firm) · Company: AM 100 Law (Hybrid) · Comp Package: Base to $120K, Paid Overtime, Tuition Reimbursement, Full Benefits, Bonus, 401K+, etc. · Responsibilities for Senior Billing Specialist (Global Law Firm): · Perform client billing ...
RN Utlization Review Specialist - New York, United States - American Consultants
Description
RN Utilization Review Specialist- New York
American Consultants is looking for an perm Utilization Review Specialist for a facility in NY. Must have New York RN license
Position Summary: Under the direct supervision of the HIM manager, the UR specialist monitors the utilization of resources, risk management and quality of care for patients in accordance to established guidelines and criteria for designated setting and status. Collection of clinical information necessary to initiate commercial payer authorization. Obtain and maintain appropriate documentation concerning services in accordance to reimbursement agency guidelines.
Excellence in PracticePerforms preadmission review on admissions when required by insurance companies/agencies to comply with policies and procedures. Works in coordination with discharge planner, monitoring medical necessity for admissions, and appropriate level of services. May also need to notify physician and patient of authorization denials.
Inputs collected data into computer system for insurance communication.
Assists with retrospective review of specified charts as required Obtains extensions in length of stays from insurance companies if needed. Obtains preauthorization and/or precertification of services.
Reviews hospital records daily to determine if utilization resources could be served in a better environment, OBS vs INPT.
Ability to interact on an interpersonal basis with providers and other staff within the organization. Innovation in Service · Serves as a role model for the organization and exemplifies the corporate values of WRHSF. · Attends all required training sessions provided by the facility and others as required for licensing. · Demonstrates understanding of emergency procedures (example, fire drills, bomb threats, tornado, disaster plans and other procedures) · Cooperates when implementing changes that affect the organization. Compassion for the people we serve · Demonstrates courtesy, cooperation and sensitivity toward patients, family and visitors. · Displays empathy and offers support for employees, patients and visitors throughout the facility. · Maintains a warm and welcoming environment for all individuals and demonstrates caring and concern.
Respect for one another · Maintains strict confidentiality of patient and organizational information. · Adheres to all Administrative and Personnel Policies (example: dress code policy, attendance policy, parking policy and all others)
· Promotes positive relationships within your own department · Promotes positive relationships with other departments within the organization
Essential Job Requirements:
Education: Appropriate education level required in according with licensure.
Experience: Three years of relevant experience with superior communication and interpersonal skills. Minimum one year healthcare or clinical experience required.
License Requirements: Registered Nurse license with State Nursing Board. Additional coding certifications also acceptable such as certified coding specialist (CCS), certified coding specialist physician (CCS-P), certified professional coder (CPC), and certified professional coder – hospital (CPC-H).
