• Certified Professional Coder

    CVS Health (Albany, NY)
    …And we do it all with heart, each and every day. **Position Summary** The Certified Professional Coder (CPC) will perform medical claim reviews to ensure ... and potential to testify **Required Qualifications** + AAPC Coding certification - Certified Professional Coder (CPC) + 3+ years of experience in medical… more
    CVS Health (11/11/25)
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  • Investigator, Coding Special Investigative…

    Molina Healthcare (NY)
    …Association** Licensed registered nurse (RN), Licensed practical nurse (LPN) and/or Certified Coder (CPC, CCS, and/or CPMA) **Preferred Education** Bachelor's ... Certified Medical CPC, CPMA, CPCO or similar specialist preferred + Certified Fraud Examiner and/or AHFI professional designations preferred To all current… more
    Molina Healthcare (10/22/25)
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  • Professional Coding Educator/Auditor

    Premier Medical Group of the Hudson Valley (Poughkeepsie, NY)
    …related experience in a healthcare setting, with 2 years experience in auditor role. Certified Professional Coder (AAPC, AHIMA)- Required Certified ... JOB TITLE: Professional Coding Educator/Auditor DEPARTMENT: Billing Department STATUS: Full...predictable attendance. + May be asked to assist with special projects. + Maintain and model Premier Medical Groups… more
    Premier Medical Group of the Hudson Valley (09/12/25)
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  • Compliance Analyst II, Urmc and Affiliates

    University of Rochester (Rochester, NY)
    …( **RHIA** ), + Certified Coding Specialist ( **CCS** or **CCS-P** ), + Certified Professional Coder ( **CPC** ), Certified Outpatient Coder ... ( **COC** ), or equivalent professional certification. + Certified in Healthcare Compliance ( **CHC** ) **2. Compliance Specialist** + **Minimum Education** -… more
    University of Rochester (10/03/25)
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  • Compliance Auditing Specialist- Remote/Hybrid…

    WMCHealth (Valhalla, NY)
    …or more of the following credentials: Certified Risk Coder (CRC), Certified Professional Coder certification (CPC), Certified Professional ... credential(s). Education: Bachelor's Degree in related field Other: Remote/Hybridavailable Special Requirements: About Us: NorthEast Provider Solutions Inc. Benefits:… more
    WMCHealth (09/12/25)
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  • Medical Review Nurse (RN)

    Molina Healthcare (Buffalo, NY)
    … Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), ... and support to clinical peers. + Identifies and refers members with special needs to the appropriate Molina program per applicable policies/protocols. **REQUIRED… more
    Molina Healthcare (10/18/25)
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  • Network Reimbursement Specialist-Associate

    Independent Health (Buffalo, NY)
    …standard claims edits and correct coding requirements required. + Current certification of Certified Professional Coder , American Academy of Professional ... to management to assist in corporate objectives as they relate to professional reimbursement. **Qualifications** + High school diploma or GED required. Associates… more
    Independent Health (11/15/25)
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  • Revenue Integrity Coordinator

    WMCHealth (Valhalla, NY)
    …Associate's Degree preferred or two years' work experience. Licenses / Certifications: Certified Professional Coder (CPC) or similar credential, preferred. ... information on status of audits and issues presented. + Works on special projects as required. + Participates in required regulatory change implementations and… more
    WMCHealth (10/08/25)
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  • Payment Integrity Clinician

    Highmark Health (Albany, NY)
    …Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** + Demonstrated ability ... SUMMARY** This job requires the ability to identify issues related to professional and facility provider claims data including determining appropriateness of code… more
    Highmark Health (11/14/25)
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  • Surgical Anesthesia Compliance Auditor

    FlexStaff (Chappaqua, NY)
    …In this pivotal role, you'll leverage your healthcare environment experience-whether as a Certified Professional Coder or similar professional -to audit ... in ancillary systems to resolve overlapping times and billing issues - Support special requests for case logs, documentation, and records for anesthesia services as… more
    FlexStaff (11/08/25)
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