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Ranked among the top hospitals in New York State, Mercy offers a NYS designated Stroke Center, Breast Imaging Center of Excellence, Level III Neonatal Intensive Care Unit, and has received Pathway to Excellence designation from the American Nurses Credentialing Center – the only hospital in the region and one of only two in NY State to receive this prestigious award.
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Working denials and creating appeals/reconsideration of claim paymentsObtaining AuthorizationsObtaining ReferralsSending out Medical Records and responding to audit requestsSending out Patient StatementsResolving billing issues with insurance carriers and patientsProvider updates and credentialing tasks.
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Registered Cardiac Sonographer (RCS) with Cardiovascular Credentialing International (CCI), required. Registered Cardiac Sonographer (RCS) with Cardiovascular Credentialing International (CCI), required.
$46.32 - $57.21 an hourPart-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Designated a Magnet® hospital by the American Nurses Credentialing Center (ANCC) for outstanding nursing care, South Nassau also offers Novalis Tx™ and Gamma Knife® radiosurgery technologies, and operates the only Trauma Center on the South Shore of Nassau County verified by the American College of Surgeons.
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Wright Public Entity serves as a management company providing claims administration, risk management & loss control, underwriting & marketing, and client services in New York for the NY Schools Insurance Reciprocal (NYSIR: 'A' rated by Best), NY Municipal Insurance Reciprocal (NYMIR: '' rated by Best) and Statewide Schools Health Plan. We also act as a TPA for Workers Compensation for various self-insured schools & municipalities in New York.
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The Sr. Claims Examiner position will be responsible for the adjustment of all litigation losses. At least five years of experience in handling general liability claims. Investigate, evaluate, and bring to a disposition all nonsuit and litigation claims.
$85,000 - $100,000 a yearFull-timeExpandApply NowActive JobUpdated 24 days ago - UpvoteDownvoteShare Job
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Handles investigation regarding all aspects of advanced auto claims (coverage, liability and damages) with the exercise discretion and independence within increased level of authority. For claims involving injuries (if handled), learns how to review, evaluate, and negotiate basic to moderate injury claims.
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Active, unrestricted license or certification to practice dental or related health profession in New York in good standing (must pass credentialing - no probation or listed sanctions). Identify potentially unnecessary services in relation to care delivery settings, potential quality issues and trends in prospective and retrospective claims submissions, and members in need of case management and/or disease management activities or interventions.
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Active RN licensed in the state where employed and board-certified by either the American Nurses Credentialing Center (ANCC) or the American Association of Nurse Practitioners (AANP) as a Psychiatric-Mental Health Nurse Practitioner (PMHNP-BC) is required - (new grads are welcome to apply post licensure.
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The Claims Supervisor, SIU will oversee the operation of a unit of SIU Investigators and Analysts with varying levels of experience who handle investigations on suspect claim and underwriting matters.
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We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology.
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Gramercy has extensive in-house experience in the areas of claims and litigation management, risk control and risk management, regulatory and compliance, underwriting, coverage analyses and business management.
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We are seeking a Claims Adjuster with experience in claims processing. Title: Claim Examiner/Claims Adjuster. Consult with legal counsel on claims requiring litigation. Investigate, evaluate, and settle claims , using technical knowledge and human relations skills to ensure fair and prompt resolution of cases and contribute to a reduced loss ratio.
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Candidate must have ability to effectively interact with all levels of customers and collaborate with a team of underwriters, claims and loss control personnel. This position must collaborate with other underwriters, operations, claims, marketing, and home office management as necessary.
$115,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Successful completion of the Registered Dietitian (RD) exam approved though the Commission on Dietetic Registration (CDR -the credentialing Agency for ADA) - must be obtained within the first six months of employment.
$40.74 - $46.8 an hourPart-timeExpandApply NowActive JobUpdated 2 days ago
claims credentialing jobs in Oceanside, NY
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