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Clinical Appeals Lead - Payer Denials & UM

Montefiore New Rochelle

Montefiore Medical Center is seeking a Clinical Appeals Manager to lead the Wakefield Division's appeals process. You will respond to third-party denials, interface with health plans and coordinate with Finance and Contracting on utilization-management issues. In this role you will mentor Case Managers/CTCCs, ensure proper documentation in the tracking system, and perform first-level reviews for Medicare admissions. Strong medical-necessity knowledge and communication skills are essential. #J-18808-Ljbffr Montefiore New Rochelle

Vacancy posted 4 days ago
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