Offres appeals nurse à Yonkers, New YorkCréer des alertes d'emploi

Annual Salary: $60k-$85k (varies depending on years of experience) An established orthopedic and spine surgery practice is seeking an experienced Medical Biller with a strong background in out-of-network billing and spine-related claims. This role is responsible for managing the full revenue cycle with a focus on accurate claims submission, payment resolution, and reimbursement optimization. Key Responsibilities • Manage end-to-end medical billing and accounts receivable for orthopedic and spine surgical cases., • Submit and track out-of-network claims to commercial payers., • Handle the Independent Dispute Resolution (IDR) process including documentation preparation, submissions, and follow-up., • Review, correct, and resubmit denied or underpaid claims in a timely manner., • Post payments, reconcile explanations of benefits (EOBs), and identify discrepancies., • Follow up aggressively on unpaid or delayed claims to ensure maximum reimbursement., • Communicate with insurance carriers regarding claim status, appeals, and payment disputes., • Work closely with the clinical and administrative teams to resolve coding and documentation issues., • Maintain strict compliance with HIPAA and billing regulations., • Generate A/R aging reports and participate in revenue cycle performance discussions., • Maintain accurate patient account records and billing documentation. Required Qualifications • Proven experience as a Medical Biller / A/R Specialist in a physician practice or surgical specialty., • Orthopedic and spine billing experience is required., • Out-of-network billing experience is required., • Independent Dispute Resolution (IDR) experience is required., • Strong understanding of commercial insurance reimbursement processes., • Excellent attention to detail, organization, and follow-through., • Ability to work independently in a fast-paced, high-volume environment., • Strong communication skills for payer and internal team interactions. — Atlas Search is a tri-state area recruitment agency, connecting new graduates, Advanced Practice Providers, Physicians and Nurse Leaders to hospitals, clinics, multi-specialty groups, nursing homes, managed care companies, private practices, and healthcare start-ups. If you would like to learn more about the opportunities we offer, please submit your CV for consideration here.

Compass Healthcare Consulting & Placement is conducting a search for an experienced RN Administrator for Admissions, Intake & Outreach for a Hospital located in the Bronx, NY. New York State Registered Nurse and Masters Degree in Nursing is required. Opportunity for Clinical RN Administrative Leader for Facility Administrator role. Qualified candidates will have 10-15 years of Management experience, 5+ years experience as a Department Head and 3+ years as an RN Administrator or VP level within a Hospital setting. RN Administrator for Admissions, Intake & Outreach is responsible for overseeing the functions and activities associated with Community Outreach Services, Admitting, and Intake. Reports directly to the Vice President for Admitting, Intake and Outreach Services and maintains an open dialogue with the senior leadership of the hospital and referring partners. Responsibilities: • Continuously monitors and assesses the delivery of services provided by the Community Outreach, Admitting and Intake implementing changes when appropriate., • Acts as liaison between Hospital and referring institutions and providers., • Actively engages in the ongoing marketing of programs and services provided by the Hospital., • Works cooperatively with other departments, provider referrers and managed care organizations to facilitate the admission of patients to the various programs provided by the Hospital., • Interfaces with managed care organizations to facilitate reimbursement for services provided by the Hospital. Oversees the appeals process for those cases for which reimbursement has been denied., • Conducts interdepartmental meetings related to the quality and utilization of clinical services., • Serves on various Hospital committees as assigned., • Attends meetings and seminars as appropriate., • Ensures all related manuals are kept current., • Works within legal, ethical practice standards to his/her position as well as the Hospital's Code of Conduct. Complies with appropriate policies and procedures and brings potential compliance matters to the supervisor or compliance officer., • Oversees and participates in the budget process for his/her assigned departments., • Completes Introductory and Annual Performance Appraisals for all direct reports. Reviews Introductory and Annual Performance Appraisals for other assigned staff., • Oversees the interface with the Finance Office regarding pertinent insurance information, e.g. Medicare, Medicaid and Commercial Insurance., • Elicits recommendations regarding continuous improvement of patient safety from staff., • Encourages reporting of occurrences without fear of reprisal., • Participates in the development of recommendations for improvement in patient safety based on staff recommendations., • Participates in the implementation and monitoring of patient safety programs., • Maintains current knowledge of regulatory requirements which may impact on the delivery of patient services., • Integrates the services of the departments supervised into the day-to-day activities of the Hospital in support of its philosophy and mission., • Develops appropriate goals and objectives for departments supervised. QUALIFICATIONS: • Master of Nursing Degree required., • NYS unencumbered Registered Nurse License required., • Ten (10) to fifteen (15) years of management experience, five (5) of which must be at the department head level. Three (3) years’ experience as an Administrator or Vice President preferred., • Excellent interpersonal skills., • Ability to interface with all levels of personnel., • Excellent written and verbal communication skills., • Ability to analyze detailed statistical and other pertinent data., • Knowledge of and experience in Quality Assessment and Improvement, Utilization Review., • Ability to develop management systems to track data over time. Competitive Salary $190,000.00 - $210,000.00 and excellent Benefits Package! 401(k), Dental insurance, Employee assistance program, Employee discount, Free parking, Gym membership, Health insurance, Health savings account, Life insurance, Paid sick time, Paid time off, Retirement plan, Tuition reimbursement, Vision insurance Qualified Candidates Please Apply Now for Immediate Consideration!