Medicare Qual Review Spec

Where The Best Belong
NewYork-Presbyterian

The University Hospital of Columbia and Cornell



Recognized as one of the best hospitals in the country by U.S. News & World Report, New York-Presbyterian Hospital with over 2,300 beds continues a long-standing emphasis on clinical expertise with our centers of excellence including New York Presbyterian/Weill Cornell, New York Presbyterian/Columbia, Morgan Stanley Children's Hospital of New York Presbyterian, Allen Pavilion, a model for community care and the Westchester Division, a world renowned behavioral health facility. World-class resources, state-of-the-art inpatient and outpatient facilities and world-renowned research and clinical leadership make this a special place.

Responsibilities
Performs all review, coding, tracking, follow-up, corrective action and educational functions required to ensure that Medicare services are reimbursed. Collaborates with project team and committee and with fiscal intermediary. Experience with a broad range of psychopathology and substantial understanding of the phenomenology, dynamics and treatment of the psychiatric population within the current behavioral health context. Substantial knowledge and skill in meeting Medicare requirements for all levels of care. Capacity to conduct case reviews, to present rationale for level of care, LOS, interventions and discharge plans. Knowledge of reimbursement protocols and billing issues pertaining to Medicare population. Capacity to collaborate with interdisciplinary staff, with other departments and with external agencies. Excellent communication and strong relationship building skills. RN, MSW, Ph.D. degree from an accredited school. A minimum of 3 years experience in mental health field after completion of degree. N.Y. State license, registration, and/or certification.

Equal Employment Opportunity
NewYork-Presbyterian Hospital is an Equal Employment Opportunity employer.