Director Pre Appeals Management-HSO Appeals Management - New York

The Director Pre Appeals Management is a strategic enterprise leader who provides strategic leadership and operational oversight for the hospital's pre-appeals management program. · ...

The Director Pre Appeals Management-HSO Appeals Management is a strategic enterprise leader who provides strategic leadership and operational oversight for the hospital's pre-appeals management program.This role ensures the appropriate use of medical resources compliance with reg ...

The Director, Pre Appeals Management is a strategic enterprise leader who provides strategic leadership and operational oversight for the hospital's pre-appeals management program. · This role ensures the appropriate use of medical resources, compliance with regulatory standards, ...

The Director, Pre Appeals Management is a strategic enterprise leader who provides strategic leadership and operational oversight for the hospital's pre-appeals management program. · Lead and manage the pre appeals department · Develop and implement pre appeals strategies · Ana ...

+Review appeals for clinical appropriateness and makes clinical decisions on approvals. · + · +Doctor of Pharmacy degree or master's in pharmacy from an accredited school of pharmacy · New York State pharmacy license preferred Board certification (Pharmacotherapy, Ambulatory Ca ...

The E-Billing Specialist will be responsible for retrieving invoices, deductions, and appeal backups from various e-billing platforms. They will review deductions, referencing client guidelines for accuracy and reporting inconsistencies as necessary. · Retrieve invoice, deduction ...

We are a leading authority in payment integrity solutions including DRG Validation, Cost Outlier and Readmission reviews.The Appeals Specialist level II performs research, investigation, · and analysis of appeals, · grievances, ...

At MedReview our mission is to bring accuracy accountability and clinical excellence to healthcare. As such we are a leading authority in payment integrity solutions including DRG Validation Cost Outlier and Readmission reviews. · ...

We are seeking an experienced insurance expert to lead our in-house insurance claims and appeals operations. · ...

Law firm seeks an experienced E-Billing Specialist to join growing Accounting team. · The specialist will retrieve invoice backups from e-billing platforms, review deductions and appeal strategies. · ...

A healthcare organization in New York City is seeking a Registered Nurse (RN) to join its Appeals & Grievances (A&G) team. · This is a Hybrid role focused on clinical case review and regulatory compliance, · Review and investigate member/provider appeals grievances medical necess ...

As a member of our Global Property Tax Advisory practice you will assist clients in identifying tax saving opportunities by reviewing their tangible property portfolio and associated property tax assessments and liabilities We currently seek a Managing Director that can lead and ...

This position reviews and manages daily mail intake to ensure all necessary documentation is complete and accurate. · ...

The e-billing specialist will be responsible for retrieving invoices and deductions from various e-billing platforms, reviewing deductions for accuracy and reporting discrepancies as necessary. They will also provide attorneys with detailed analysis of deductions and suggestions ...

Manage property tax compliance function on a nationwide basis; Manage a national property tax calendar for compliance return due date assessment appeal dates appeal filing deadlines and tax payment dateManage current client engagements and be able to identify opportunities to exp ...

Review, manage and triage daily mail intake, including appeals email inbox, to ensure all necessary documentation is complete and accurate. · ...

+ Provide clinical information to Managed Care/Insurance Companies/BHO for reimbursement; responsible for concurrent review program, insurance certification, authorization process in Psychiatric or Chemical Dependency Inpatient Units + Develops rapport with admitting clinicians f ...

To provide clinical information to Managed Care/Insurance Companies/BHO to demonstrate medical necessity and ensure reimbursement. · Responsible for all aspects of the concurrent review program, insurance certification, and authorization process. · Develops rapport with and daily ...

We are seeking an experienced insurance expert to lead our in-house insurance claims and appeals operations. · 7+ years of experience in healthcare insurance billing, claims, and appeals ...