• Coding Specialist (Revenue Integrity…

    Northwell Health (Westbury, NY)
    …and resolves accounts that have failed coding and charging related claim edits, including departments requiring clinical/coding expertise. Responsible for validation ... of items, assuring the appropriate assignment of coding system, modifier(s) and revenue codes, by reviewing medical record documentation, facility protocol, regulatory guidance and other applicable documentation. Job Responsibility + Adheres to regulations and… more
    Northwell Health (11/20/25)
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  • AVP- Complex Claim Specialist

    Travelers Insurance Company (Albany, NY)
    …experience. + 5-10 years experience handling serious injury and complex liability claims preferred (casualty claim operations environment determining ... claim handling and superior customer service on assigned claims , while engaging in indemnity & expense management. Promptly...of some of the Company's severe and complex liability claims by providing claim handling guidance, recommendations… more
    Travelers Insurance Company (11/12/25)
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  • Long Term Disability Claims…

    MetLife (Oriskany, NY)
    …Organizational and time management skills Preferred: * Bachelor's degree Business Category Operations - Claims At MetLife, we're leading the global ... meeting all key performance indicators * Provides timely, balanced and accurate claims reviews, documentation and recommended decisions in a time sensitive and… more
    MetLife (11/26/25)
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  • Hospital Claims Relationship…

    Healthfirst (NY)
    …Diploma or GED equivalent + Direct experience working with managed care operations and/or health plans + Claims experience including root-cause analysis, ... hospital partners_** including but not limited to roster maintenance and claim issue root cause analysis + **_Managing education/training regarding company-wide… more
    Healthfirst (09/12/25)
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  • Claims Representative

    CDPHP (Latham, NY)
    …and adjustments. In addition, the incumbent will utilize and interpret Claims Operations Policies and Procedures, coding methodologies, Plan contract ... incumbent will work closely with all departments such as Member Services, Claims Operations , Provider Relations, Health Care Network Strategy, Configuration and… more
    CDPHP (11/20/25)
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  • Self Directed Billing Specialist - Arc…

    Arc Allegany-Steuben (Wellsville, NY)
    …money, why wait to be paid! Job Summary The Self Direction Billing Specialist is responsible for ensuring timely, accurate, and compliant billing for services ... submitted to accounting on a monthly basis. The Billing Specialist plays a key role in maintaining fiscal accountability...Management + Review, prepare, and submit Self Direction billing claims through eVero on a monthly basis. + Cross-check… more
    Arc Allegany-Steuben (11/13/25)
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  • Senior Revenue Cycle Specialist

    Stony Brook University (East Setauket, NY)
    Senior Revenue Cycle Specialist **Position Summary:** At Stony Brook Medicine, the **Senior Revenue Cycle Specialist ** will act as an operational leader in the ... but are not limited to:** + Develops staff work listing logic/strategy and claims resolution work flows. + Educates and trains new staff regarding departmental/unit… more
    Stony Brook University (11/22/25)
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  • (Remote) EDI Support Specialist - Casualty

    Sedgwick (Albany, NY)
    …Fortune Best Workplaces in Financial Services & Insurance (Remote) EDI Support Specialist - Casualty **PRIMARY PURPOSE** **:** To identify, research, resolve, and ... that impact EDI. + Oversees complex EDI troubleshooting; notifies operations and external customers of state acknowledgement delays, error...to include two (2) years of workers' compensation or claims related experience and three (3) years of EDI… more
    Sedgwick (11/06/25)
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  • Revenue Specialist

    Stony Brook University (East Setauket, NY)
    Revenue Specialist **Position Summary** At Stony Brook Medicine, a **Revenue Specialist ** will provide operational support within the hospital's Patient ... support day-to-day business functions including but not limited to: billing, claims analysis appeals, follow-up, financial assistance and customer service. **Duties… more
    Stony Brook University (11/21/25)
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  • Program Research Specialist 1/Trainee…

    New York State Civil Service (Albany, NY)
    …Medicaid Inspector General, NYS Office of the Title Program Research Specialist 1/Trainee 1/Trainee 2 Occupational Category Other Professional Careers Salary Grade ... contractor-submitted data for accuracy and completeness.* Review and vet claims prior to the issuance of each DAR/FAR to...Access, Excel, and SQL Developer to analyze and verify claim data in monthly data feeds, OMIG projects, and… more
    New York State Civil Service (11/18/25)
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