We have other current jobs related to this field that you can find below

  • Financial Investigator Line

    1 month ago

    Bronx, United States BronxCare Health System Full time

    Overview: Secure pre-authorizations for medical and ancillary services. Communicate on a daily basis with practice managers, clinicians and staff to ensure that visits are appropriately registered, and meet all insurance pre-authorization requirements. Posting internally from Oct 23-Oct 30 Responsibilities: - Establish and maintain positive relationships...

  • Investigative Settlement Specialist

    6 days ago

    Bronx, New York, United States City of New York Full time

    **Remote Work Eligibility:** This role may allow for remote work up to 2 days per week, in accordance with the Remote Work Pilot Program. **Eligibility Requirements:** Only permanent employees in the title, comparable titles, and those eligible for the 55A program may apply. **About the Department:** The City of New York's Department of Consumer and Worker...

  • RN Clinical Risk Manager- Hospital Bronx, NY

    3 months ago

    Bronx, United States Tandym Group Full time

    An established healthcare system in New York is actively seeking a Clinical Risk Manager to join their growing team!About the Opportunity Location: Bronx Specialty: Risk Management Schedule: Full-time. Monday through Friday, standard business hours Reporting to: the Director of Risk Management and the Chief Quality Officer Responsibilities: the clinical risk...

  • Residential Operations Supervisor

    2 days ago

    Bronx, New York, United States IAHD Full time

    IAHD is seeking a dedicated and experienced Residential Operations Supervisor to oversee a cluster of Residence Managers, Assistant Managers, and Shift Supervisors across our Bronx and Westchester County locations. As a key member of our leadership team, you will play a vital role in ensuring the smooth operation and well-being of individuals residing in our...

  • Nurse Practitioner

    3 months ago

    Bronx, United States Department Of Veterans Affairs Full time

    Summary This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific individual eligibility requirements in accordance with VHA policy and submit your EDRP application within four months of appointment....

  • Senior Grant Specialist

    3 months ago

    Bronx, United States Albert Einstein College of Medicine Full time

    POSITION RESPONSIBILITIES: Serve as primary contact for users of the Einstein College of Medicine Cayuse 424 & SP Grant Application Resource. Oversee the deadline-sensitive electronic submission of competitive grant applications (~500/yr) for all researchers at Einstein College of Medicine and Montefiore Medical Center. This includes defining and ensuring...

  • Grants Administrator

    1 month ago

    Bronx, United States Albert Einstein College of Medicine Full time

    POSITION RESPONSIBILITIES: Responsibilities: Responsible for working with faculty and students to prepare research grants and fellowship applications to the NIH, other federal and state agencies, public and private organizations and foundations; including but not limited to budget preparation, preparing proposal packages via Cayuse, eRA Commons, agency...

  • Staff Counsel

    2 months ago

    The Bronx, United States City of New York Full time

    *** This position may be eligible for remote work up to 2 days per week, pursuant to the Remote Work Pilot Program agreed with the City *** ***To Apply: Email your resume and cover letter to with the Job ID number and Position Name in the subject line*** The NYC Department of Consumer and Worker Protection (DCWP) protects and enhances the daily economic...

  • Area Coordinator

    1 month ago

    Bronx, United States IAHD Full time $70,000 - $72,000

    The Area Coordinator will be responsible for overseeing a cluster of Residence Managers, Assistant Managers and Shift Supervisors.Day-to-day responsibilities include but are not limited to:The Area Coordinator is responsible for maintaining a safe environment by inspecting the physical plant of each residence on a regular basis. The Area coordinator is...

  • Trial Attorney

    4 weeks ago

    Bronx, New York, United States Allstate Insurance Company Full time

    At Allstate, great things happen when our people work together to protect families and their belongings from lifes uncertainties. And for more than 90 years our innovative drive has kept us a step ahead of our customers evolving needs. From advocating for seat belts, air bags and graduated driving laws, to being an industry leader in pricing sophistication,...

  • Impact Data Analytics Intern

    5 days ago

    Bronx, United States World Vision Full time

    VisionFund's work seeks to end intergenerational poverty through financial products and services. We're about the long-term change that ensures children can break free of the poverty cycle, for good. By supporting people and communities living in poverty to develop and grow their livelihoods, VisionFund is catalysing sustainable economic growth to break the...

  • Case Resolution Specialist

    3 months ago

    The Bronx, United States City of New York Full time

    DSS Community Outreach is dedicated to expanding access to information and resources about HRA and DHS programs in the community by bringing services directly into the community and by partnering with and serving as a resource to community-based provider organizations serving HRA and DHS clients and applicants. Community Partnerships establishes and manages...

Financial Investigator

2 months ago

Bronx, United States BronxCare Health System Full time

Overview:

Secure pre-authorizations for medical and ancillary services. Communicate on a daily basis with practice managers, clinicians and staff to ensure that visits are appropriately registered, and meet all insurance pre-authorization requirements.

Responsibilities:

- Establish and maintain positive relationships with patients, visitors, and other employees. Interacts professionally, courteously, and appropriately with patients, visitors and other employees. Behaves in a manner consistent with maintaining and furthering a positive public perception of BronxCare Health System and its employees.


- Contributes to and participates in the Performance/Quality Improvement activities of the assigned department. Contribution and participation includes data collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement (CQI) teams, consistent adherence to the specific rules and regulations of the BronxCare Health System (a) Safety and Security Policies, (b) Risk Management: Incident and Occurrence Reporting, (c) Infection Control Policies and Procedures and (d) Patient and Customer Service.


- Insures authorization requests are obtained and processed for medical and ancillary services on a timely basis and manage the accurate submission of authorization requests and the entry of authorization to Allscripts Clinical Registration System


- Responds in a timely manner to the pre-authorization, authorization and pre-certification requests of various points of service areas located within BronxCare Health Systems ambulatory practices.


- Retrieves and reviews patient utilization data to secure authorization for scheduled services. Updates BxCare practice administrative personnel and Care Providers regarding authorization decisions rendered by insurance carriers


- Navigates Allscripts EMR (Acute Care) and communicates with Practice Administrative staff or Care providers to retrieve required clinical utilization data to facilitate insurance carrier review and expeditious authorization approval


- Communicate on a daily basis with practice managers, clinicians and PFS staff to ensure that visits are appropriately registered, meet all insurance pre-authorization requirements and increase revenue by reducing payment denials for unauthorized services.


- Maintains accurate and complete reporting deliverables showing productivity and outstanding items to be addressed, conducts follow up on outstanding cases as needed.


- Act as a liaison with clinics, physicians, patients, staff, insurers and ancillary departments and maintain a positive relationship with all.


- Maintain the highest level of professionalism and confidentiality at all times to ensure compliance with Federal/State regulations such as HIPAA and EMTALA..

Qualifications:

- Minimum Two (2) years experience of Hospital/Healthcare in Financial Investigations and/or Insurance Verification and/or Insurance Authorization

- Excellent Customer Service Skills

- High School or GED

- Associates

- Basic Computer knowledge