Appeals Manager Salary at Jzanus Ltd BETA

Job Description Job Description Apply Here: https://www.applitrack.com/leaguers/onlineapp/ The Leaguers, Inc., founded in 1943, is a multi-cultural program servicing over 1,700 families a year providing high-quality early Childhood Education in Newark, Irvington, Roselle, and Elizabeth. Our mission is to enhance the quality of life for children and families through diverse educational and cultural programs that foster self-growth, personal development, and pride in one’s community. We strongly believe in “Opportunity through Education.” Head Start and Early Head Start Teachers Additionally, The Leaguers, Inc. provides a comprehensive compensation package including: Benefit Package (Health, Dental and Life Insurance) 403-B Retirement Plan Twelve (12) Month Position with a 2-week paid break in August Sick and personal days 14 Paid Calendar Holidays Winter and Spring Recess State-of-the-Art Classrooms Professional Training The Infant/Toddler Teacher is responsible for preparing lesson pla

Entry-Level Insurance Defense Attorney Location: Farmingdale, NY Job Type: Permanent About our client Our client is a small but dynamic law firm specializing in insurance defense litigation. They are committed to providing top-tier legal representation to their clients while fostering a collaborative and supportive environment for their attorneys. Job Description: They are seeking a motivated Entry-Level Insurance Defense Attorney who has successfully passed the New York State Bar and is eager to gain hands-on litigation experience. This role offers an opportunity to be actively involved in all phases of the litigation process, from initial investigation through trial and appeal. Responsibilities: Appear in court for motions, hearings, depositions, and trials. Draft pleadings, motions, briefs, and other legal documents. Conduct legal research to support case strategy and client advocacy. Communicate with clients, opposing counsel, courts, and insurance carriers. Prepare and draft statu

Description We are seeking a detail-oriented Medical Biller to join our hospital's financial services team in Manhattan. The ideal candidate will be responsible for accurately processing medical claims, review and follow up on denied or rejected claims, handling insurance reimbursements, and ensuring timely patient billing. Key Responsibilities: Perform insurance follow-up calls to investigate the reasoning for claims being denied by the carrier. Submit appeals and follow up on denied or rejected claims to seek resolution for payment from insurance carrier Prepare and submit claims to Medicare, Medicaid, private insurance carriers, no fault and workers comp insurance carriers Submit appeals and follow up on denied or rejected claims to ensure timely resubmission. Verify and process patient insurance information, ensuring accuracy in billing codes (CPT, HCPCS, ICD-10). Post payments and adjustments while reconciling accounts receivable. Handle patient billing inquiries and set up paymen

About the Firm: Held & Hines, LLP is a well-established, client-focused litigation firm based in Brooklyn, New York, with a proven track record of achieving favorable outcomes for our clients. We are committed to providing exceptional legal services, advocating for the rights of individuals who have been harmed due to accidents, negligence, and police misconduct. Our team fosters a collaborative, dynamic, and supportive work environment. Position Overview: We are seeking a dedicated and skilled attorney with at least 3 years of litigation experience to join our team. The ideal candidate will have a strong passion for advocating on behalf of injured individuals and will be experienced in handling personal injury cases from inception through trial. You will work alongside a talented team of attorneys and staff to ensure clients receive the compensation they deserve. Responsibilities: Represent clients in personal injury and other matters, including but not limited to motor vehicle accide

The Director of Claims Integrity and Analytics is responsible for leading the comprehensive management of claims payment processes, ensuring the accurate and timely execution of claims. This includes overseeing third-party administrator (TPA) performance, maintaining the integrity of payment configurations, and managing claims appeals. The position requires collaboration with internal teams and external partners to ensure that claims payments are processed in accordance with contractual agreements and regulatory requirements. The role will also focus on optimizing the medical payment process to reduce costs and improve outcomes, while ensuring compliance with applicable regulations to prevent fraud, waste, and abuse (FWA). A strong understanding of healthcare policies, payment methodologies, and advanced analytical skills are essential. Key Responsibilities: Claims Payment Integrity: Oversee and ensure accurate and timely claims payment processing, including managing vendor relationshi

Are you a Retail Account professional who thrives in a fast-paced entrepreneurial environment where you will be both rewarded for your efforts and afforded the opportunity to take your career to the next level? Would a role offering exposure to worldwide markets, as well as to senior management, be appealing to you? If so, this Senior Financial Analyst opportunity could be for you. See what people are saying about working here: “Senior Management is top shelf!” “Great opportunity to work with a successful entrepreneurial-focused company!” “Excellent training on new technologies!” “Great fringe benefits!” Title: Account Retail Specialist - Hybrid Salary: $75,000 to $100,000, Bonus upt o 30% Location: Rye, NY A highly successful and growing industrial products company is seeking to hire a talented Accountant Retail Specialist to perform a variety of procurement responsibilities including ensuring the accuracy of orders, inventory integrity, and invoicing. The successful candidate will al

Overview: The Denial Appeals Specialist, functions as a hospital liaison with external third-party payers to review denied claims and write appeals for such claims and retrospectively pre-certify Medicaid, Medicare and private insurance accounts. Responsibilities: Responsible for utilization chart reviews. Review denials and make determination as to the admission met clinical criteria for inpatient level of care. Focuses on the review and analysis of governmental denial rationales and provides appropriate medical necessity appeal services. Reviews governmental contractors response letter in comparison to the medical records. Audits and coordinates completion of patient records required to retrospectively pre-certify accounts and appeal insurance denials. Identifies areas for documentation and/or process improvement and promotes pro-active documentation compliance for reimbursement. Demonstrates dynamic ability to adapt to ongoing changes within the health insurance industry in order to

Overview: The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of clinical records for the patient population and HackensackUMC. These include but are not limited to utilization review, hospital reimbursement, clinical compliance, case management, and transitions of care, as outlined in the responsibilities below. Responsibilities: 1. Regulatory compliance a. Provides direction and support regarding CMS & NJDOH regulations governing Utilization Management & Clinical documentation. b. Oversight for accurate patient status determinations - OBS vs. Inpatient c. Liaison to the Medical Staff supporting Utilization Management Committee processes d. Hospital Based Appeals Management e. Provides guidance and interpretation on issues of medical appropriateness and level of care needs 2. Liaison between medical staff and other clinical staff by being: a. Excellent communicator b. Broad spectrum cli