Location: Poughkeepsie, New York US
Requisition Number: 14205-1
Nuvance Health has a network of convenient hospital and outpatient locations — Danbury Hospital, New Milford Hospital, Norwalk Hospital and Sharon Hospital in Connecticut, and Northern Dutchess Hospital, Putnam Hospital Center and Vassar Brothers Medical Center in New York — plus multiple primary and specialty care physician practices locations, including The Heart Center, a leading provider of cardiology care, and two urgent care offices. Non-acute care is offered through various affiliates, including the Thompson House for rehabilitation and skilled nursing services, and the Home Care organizations.
In collaboration and working closely with the Corporate Denial Nurses, Case Management Operation Coordinators, and Insurance companies to identify and communicate the clinical denials in a timely manner.
Reviews Utilization Management fax queue and saves the documents
Identifies retro denials and documents appropriately
Notifies new retro denials to Corporate Denial nurses in a timely manner.
Communicates with insurance companies to schedule a peer-to-peer review and follow up on the outcomes
Prepares monthly data for the management
Interacts professionally with team members within the department, other departments, and insurance companies
Demonstrates the ability to be flexible and organizes during stressful situations
Fulfills all compliance responsibilities related to the position
High School Diploma
Excellent interpersonal skills, Experiences with Windows based computer system: MS office – word, excel, MS Teams
Preferred: Previous hospital or other health care setting experience
Location: Vassar Brothers Medical Center
Work Type: Full-Time
Standard Hours: 40.00
Work Schedule: Day 8
Work Shift: Monday thru Friday from 8am to 4:30 pm
Org Unit: 1768
Department: Denial Mgmt
EOE, including disability/vets.
We will endeavor to make a reasonable accommodation to the known physical or mental limitations of a qualified applicant with a disability unless the accommodation would impose an undue hardship on the operation of our business. If you believe you require such assistance to complete this form or to participate in an interview, please contact Human Resources at 203-739-7330 (for reasonable accommodation requests only). Please provide all information requested to assure that you are considered for current or future opportunities.
State: New York
Community / Marketing Title: Operations Coordinator
Health Quest and Western Connecticut Health Network have combined to form a new nonprofit health system. The name for the new health system will be Nuvance Health. The new health system was created to provide communities across New York’s Hudson Valley and western Connecticut with more convenient, accessible and affordable care.
EEO Employer Verbiage:
Location_formattedLocationLong: Poughkeepsie, New York US
Job Number: 47914