• Manager , Fraud and Waste

    Humana (Albany, NY)
    …community and help us put health first** The Special Investigations Unit Manager leads and monitors investigations of allegations of fraudulent and abusive ... practices. The Manager , Fraud and Waste works within specific guidelines and...Bachelor's Degree + Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years of… more
    Humana (08/09/25)
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  • Patient Accounts Manager (Billing Project…

    Mount Sinai Health System (New York, NY)
    **Job Description** **Patient Accounts Manager (Billing Project Management) Patient Financial Services- Corporate- Full-Time Days** The Patient Accounts Manager ... collected accurately and in a timely manner. **Qualifications** + HS/GED. Bachelors degree preferred . + 5 years of experience in a Patient Accounts with 2-3 years… more
    Mount Sinai Health System (08/03/25)
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  • Pharmacy Operations Manager

    Walgreens (Queens Village, NY)
    …others accountable for efficient workflow. + At the direction of the Pharmacy Manager or pharmacist, prepares, and files reports and records required by the company ... maintenance of pharmacy department equipment. In collaboration with Pharmacy Manager , responsible for recordkeeping and ensuring security safeguards are in-place.… more
    Walgreens (08/09/25)
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  • Pharmacy Manager

    Walgreens (Depew, NY)
    …events that reflect the unique communities we serve as requested by Store Manager , Healthcare Supervisor, or District Manager . Operations + Counsels patients and ... that elements of Good Faith are present. + Collaborates with Store Manager to define and develop new strategic business opportunities. + Maintains information… more
    Walgreens (08/08/25)
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  • Special Investigation Unit (SIU) Coding Review…

    CVS Health (Albany, NY)
    …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 Unit ... reviews for medical, behavioral, transportation, and other healthcare providers. The CPC Manager will be responsible for guiding the team in determining correct… more
    CVS Health (08/08/25)
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  • Patient Accounts Receivable Billings…

    Charles Evans Center (Bethpage, NY)
    Patient Accounts Receivable Billing Manager Schedule: Full-Time Monday-Friday Salary: $100,000-$110,000/year Location: Bethpage, NY (Hybrid Schedule) The Charles ... four locations in Nassau and Suffolk Counties. We are currently seeking a Billing Manager to oversee and enhance our revenue cycle operations. This role will serve… more
    Charles Evans Center (07/31/25)
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  • Service Rep Member / OPEIU

    Highmark Health (Albany, NY)
    …fraud cases and forwards to Special Investigations Unit. E3. Adjusts claims : *Performs online transactions and/or adjustments. *Determines claim disposition ... inquires from subscribers, members, providers, internal and external customers; Adjusts claims . This is a bargaining unit position. The collective bargaining… more
    Highmark Health (07/29/25)
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  • Case Manager Registered Nurse - Specialty…

    CVS Health (Albany, NY)
    …+ This position consists of working intensely as a telephonic case manager with patients and their care team for fully and/or self-insured clients. ... presents cases at case conferences for multidisciplinary focus to benefit overall claim management. + Using a holistic approach, consults with clinical colleagues,… more
    CVS Health (08/10/25)
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  • Revenue Cycle Management, Integrations…

    Cardinal Health (Albany, NY)
    …through billing and collections._ The **Revenue Cycle Management (RCM) Integrations Manager ** plays a critical role in ensuring the smooth onboarding and ... revenue cycle workflows, including eligibility and benefits, authorizations, charge capture, claim submission, and payment posting. + Identify risks and roadblocks… more
    Cardinal Health (07/26/25)
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  • QA Audit Manager - Operations

    Healthfirst (NY)
    …Experience in Healthcare/Health Plan customer service, operations, vendor management, or claims processing. + Previous work experience in an auditing function ... editing documents. + Experience with troubleshooting and process improvement. ** Preferred Qualifications** + Demonstrated experience or deep understanding of… more
    Healthfirst (08/08/25)
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