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DIRECTOR CLINICAL DENIALS MANA

TARRYTOWN, NY, US


Montefiore Medical Center

 

Director of Clinical Denials Management:

 

The Director of Clinical Denials Management provides strategic vision and direction for the Clinical Denials Management program.  Leads process improvement initiatives to prevent denials.

 

Bachelor's Degree required.  RN with Bachelor's Degree required.  7 years experience.  The candidate must be flexible and able to work between both Yonkers and Tarrytown offices also.

 

Minimum Qualifications: 

1. Three to five years of progressive experience in appeal/denial management- Required 

2. Three to five years management experience preferred- Required 

3. Strong knowledge of health plan requirements 

4. Three to five years of progressive experience with utilization management or care management is required.

5. Knowledge of EPIC enterprise system preferred. 

6. Knowledge of coding guidelines, both ICD-10 and CPT is preferred.  

7. CCS Preferred.

8. Knowledge of federal, regional and state payer coverage patterns (CMS, fiscal intermediary, and Administrative Law Judge).

9. Excellent communication and interpersonal skills. 

10. Strong analytical and statistical analysis skills required and Microsoft Excel, Word and PowerPoint skills required.

 

 

 

Department: Revenue Cycle Bargaining Unit: Non Union Campus: YONKERS  Employment Status: Regular Full-Time Address: 3334 Steuben Avenue, Bronx
Shift: Day Scheduled Hours: 8:30 AM-5 PM Req ID: 96852 

 

Montefiore is an equal employment opportunity employer. Montefiore will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law. 

 

N/A 


Mission:
To heal, to teach, to discover and to advance the health of the communities we serve.

Vision:
To be a premier academic medical center that transforms health and enriches lives.

Values
Define our philosophy of care, they shape our actions and motivate and inspire us to pursue excellence and achieve the goals we have set forth for the future. Our values include:

  • Humanity
  • Innovation
  • Teamwork
  • Diversity
  • Equity

 

 

 


Nearest Major Market: White Plains
Nearest Secondary Market: New York City

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