• Customer Solutions and Claims

    Nestle (Holbrook, NY)
    …and nutrition for patients and consumers. **POSITION OVERVIEW:** The Customer Solutions and Claims Specialist serves as the primary point of contact for the ... sales force throughout the customer order management process. The Specialist role manages high order volume on all NHS...for our customers, sales force and internal cross functional business partners. The incumbent is expected to be an… more
    Nestle (10/10/25)
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  • Specialist , Config Oversight (healthcare…

    Molina Healthcare (Rochester, NY)
    …communicate written and verbal + Knowledge of verifying documentation related to updates/changes within claims processing system . + Experience using claims ... to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system...coding, abuse and fraudulent billing practices, waste, overpayments, and processing errors of claims . ( _Use for… more
    Molina Healthcare (09/24/25)
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  • Specialist , Provider Network…

    Molina Healthcare (Rochester, NY)
    …Provider Network Operations, Hospital or Physician Billing, or similar. + Claims processing background including coordination of benefits, subrogation, and/or ... **JOB DESCRIPTION** **This role will have standard EST business hours.** **Job Summary** Provider Network Administration is...claims and provider databases. Staff ensure adherence to business and system requirements of internal customers as it… more
    Molina Healthcare (08/14/25)
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  • Medical Billing & Denials Specialist

    Rochester Regional Health (Rochester, NY)
    …actions. RESPONSIBILITIES: + Medical Billing Expertise: Proficient in billing, claims processing (Inpatient, Outpatient, Critical Access, Rural Health), ... of medical terminology, physician fee schedules, DRGs, and reimbursement procedures. + Claims and Appeals Processing : Submits and follows up on insurance… more
    Rochester Regional Health (09/20/25)
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  • Billing Specialist - Pharmacy Technician

    Independent Health (Buffalo, NY)
    …Reliance Rx Operations & Compliance department. + Experience working with online claims processing system preferred. + Effective oral and written communication ... a culture that fosters growth, innovation and collaboration. **Overview** The Billing Specialist assists with the various activities of the pharmacy operations not… more
    Independent Health (09/10/25)
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  • Specialist , Appeals & Grievances

    Molina Healthcare (Buffalo, NY)
    …concisely, accurately and in accordance with regulatory requirements. * Researches claims processing guidelines, provider contracts, fee schedules and systems ... or equivalent combination of relevant education and experience. * Health claims processing experience, including coordination of benefits (COB), subrogation… more
    Molina Healthcare (10/16/25)
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  • Leave Management & Payroll Specialist

    Loretto Management Corporation (Syracuse, NY)
    …Partners closely with HR Business Partners on all related leave of absence claims . Meets regularly to review the status of claims and develops legally sound ... Overview The Leave Management/Payroll Specialist is responsible for coordinating the organization's leave...organization's leave of absence program and assisting with the processing of the bi-weekly payroll. This role will serve… more
    Loretto Management Corporation (10/16/25)
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  • Neuroscience Hospital Specialist

    Otsuka America Pharmaceutical Inc. (Rochester, NY)
    …Hospital Specialist will report directly to the respective Area Business Lead, coordinating with cross-functional colleagues in Medical, Market Access, and ... of everyday health. In its evolved customer engagement model, a Hospital Specialist engages healthcare providers (HCPs) using in-person, virtual, and digital tools,… more
    Otsuka America Pharmaceutical Inc. (09/13/25)
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  • Specialist , Appeals & Grievances

    Molina Healthcare (Rochester, NY)
    …concisely and accurately, in accordance with regulatory requirements. + Research claims processing guidelines, provider contracts, fee schedules and system ... + Min. 2 years operational managed care experience (call center, appeals or claims environment). + Health claims processing background, including… more
    Molina Healthcare (10/16/25)
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  • Data Entry Specialist

    MVP Health Care (Rochester, NY)
    …+ Proficiency in Microsoft Word and Excel. + Familiarity with medical terminology and claims processing . + Curiosity to foster innovation and pave the way for ... To achieve this, we're looking for a Data Entry Specialist to join #TeamMVP. If you have a passion...High School Diploma or GED required; Associate's degree in Business or related field preferred. + The availability to… more
    MVP Health Care (10/16/25)
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