Career Opportunities

How you move is why we’re here. ® Now more than ever. Get back to what you need and love to do. The possibilities are endless...   Now more than ever, our guiding principles are helping us in our search for exceptional talent - candidates who align with our unique workplace culture and who want to maximize  the abundant opportunities for growth and success.   If this describes you then let’s talk!   HSS is consistently among the top-ranked hospitals for orthopedics and rheumatology by U.S. News & World Report. As a recipient of the Magnet Award for Nursing Excellence, HSS was the first hospital in New York City to receive the distinguished designation. Whether you are early in your career or an expert in your field, you will find HSS an innovative, supportive and inclusive environment. Working with colleagues who love what they do and are deeply committed to our Mission, you too can be part of our transformation across the enterprise.   Denials Specialist Denials Management Full Time    The Denials Specialist will have responsibility for the management, reporting, recovery, and prevention of clinical and technical denials received on Hospital services.   The Denials Specialist will report to the Supervisor, Denials Management.   RESPONSIBILITIES: The specific responsibilities include, but are not limited to: - Reviews claims in which a denial has been received from the payer - Identifies the root cause of the denial and addresses the denial issue with the appropriate department (i.e., Billing, CDM, Clinical Documentation, Coding, etc.) - Utilizes available resources to effectively research claims and complete steps to submit information necessary to process or appeal claims - Communicates trends in the claim denial populations to the leadership team - Investigates and ensures that questions and requests for information are responded to in a timely and professional manner to ensure resolution of outstanding claims - Completes and requests adjustments to a claim, as appropriate - Organizes work/ resources to accomplish objectives and meet deadlines - Demonstrates problem-solving skills related to denial analysis - Manages multiple responsibilities with ease and completes tasks as assigned - Demonstrates the willingness and ability to work collaboratively with other key internal and external staff, both clinically and administratively to obtain necessary information to address denial management issues - Participates in all educational activities, and demonstrates personal responsibility for job performance - Assists in the development of training material - Uses supplies and equipment effectively and efficiently - Consistently demonstrates a positive and professional attitude at work - Meets productivity requirements to ensure excellent service is provided to customers - Maintains compliance with established corporate and departmental policies and procedures - Maintains stable performance under pressure and handles stress in ways to maintain relationships with patients, customers, and co-workers - Maintain satisfactory attendance and punctuality record as set forth by HSS policies - Responsible for the other relevant work functions, as requested  

How you move is why we’re here. ® Now more than ever. Get back to what you need and love to do. The possibilities are endless...   Now more than ever, our guiding principles are helping us in our search for exceptional talent - candidates who align with our unique workplace culture and who want to maximize  the abundant opportunities for growth and success.   If this describes you then let’s talk!   HSS is consistently among the top-ranked hospitals for orthopedics and rheumatology by U.S. News & World Report. As a recipient of the Magnet Award for Nursing Excellence, HSS was the first hospital in New York City to receive the distinguished designation. Whether you are early in your career or an expert in your field, you will find HSS an innovative, supportive and inclusive environment. Working with colleagues who love what they do and are deeply committed to our Mission, you too can be part of our transformation across the enterprise.   Payor Enrollment Coordinator Managed Care   The Payor Enrollment Coordinator will be primarily responsible for coordinating physician and non-physician enrollment into the Managed Care Plans.  This position will work independently and as a valued team member supporting the coordination of all operational aspects of the enrollment/credentialing program, including organizing, compiling key informational data and executing processes and procedures related to internal and external credentialing/appointment, re-credentialing and profile maintenance.  Assignments are planned and executed with considerable independence in conformance with established policies, regulations, and laws. Duties and Responsibilities The duties include, but are not limited to: - Initiates and coordinates the acquisition and receipt of enrollment/credentialing documentation from new and existing providers; provides follow-up and problem resolution as required.   - Coordinates the processing, distribution, and management of all credentialing and accreditation documents for affected providers.   - Collaborates with internal departments (Patient Access, Medical Staff, Physician Practice Management etc.) to ensure smooth on-boarding of providers into HSS PHO - Assist in the maintenance of accuracy and completeness of internal credentialing database (Cactus). - Review payer plan applications returned to department for accuracy and completeness, troubleshooting as needed.   - Plan, implement and maintain delegated credentialing processes/status with insurance companies. - Assist in ensuring that provider participation in the payer plans and CAQH is current, accurate and up to date.   - Assist with for inputting credentialing information into the departmental credentialing system, as necessary to support the Credentialing process.   - Must actively process forms, requesting payer applications, maintaining file system, following up on issues and troubleshooting problems.   - Maintains and ensures strict confidentiality of files and databases.   - Other duties as assigned.