• Special Investigation Unit (SIU) Coding Review…

    CVS Health (Albany, NY)
    …we do it all with heart, each and every day. The Certified Professional Coder (CPC) Manager will oversee a team of medical coders within the Special Investigations ... focus on meeting state, federal, and company requirements while identifying concerning billing patterns or trends. **Responsibilities:** + Lead and mentor a team of… more
    CVS Health (08/08/25)
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  • Revenue Integrity Analyst II

    Intermountain Health (Albany, NY)
    **Job Description:** This position is responsible for billing , follow-up, and resolving issues that delay or prevent payment of the patient's account within ... hire. Plus one of the following certifications: Current certification as a coder through AAPC or American Health Information Management Association (AHIMA), or… more
    Intermountain Health (08/13/25)
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  • Senior Coding Educator

    Humana (Albany, NY)
    …+ High school diploma or equivalent + Must hold AAPC CPC (Certified Professional Coder ) certification + 2 years or more experience with ICD-10 CM guidelines + Prior ... education + Strong knowledge of medical record review + Understanding of billing , claims submission, and related processes + Proficient in Microsoft Word, Excel,… more
    Humana (08/08/25)
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  • Risk Adjustment Coding Coordinator I/II

    Excellus BlueCross BlueShield (Rochester, NY)
    …to peer guidance through informal discussion and over read assignments. Supports coder training and orientation as requested by leadership. * Maintains accuracy in ... conventions and payment rules as they apply to medical record documentation, billing of medical services, and health care reimbursement systems. * Comprehensive… more
    Excellus BlueCross BlueShield (08/08/25)
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  • Risk Adjustment Coding Specialist -St. Peter's…

    Trinity Health (Albany, NY)
    …(CMS). **SKILLS, KNOWLEDGE, EDUCATION AND EXPERIENCE:** **. Certified Risk Adjustment Coder (CRC) required** . Excellent verbal and written communication skills. . ... EHR by the providers to claims being submitted for their services. Using billing system work queues and natural language processing (NLP) tools to support addressing… more
    Trinity Health (07/31/25)
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  • Clinical Reimbursement Manager; HSO Drg…

    Mount Sinai Health System (New York, NY)
    …guidelines. Validates the accuracy and appropriateness of the DRG assignments flagged pre- billing . Determines if a secondary review is required to verify assignment ... documentation of medical diagnoses or conditions that are clinically evident. Reviews coder queries to determine if the query is supported and generates query… more
    Mount Sinai Health System (07/17/25)
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