• Specialist , Config Oversight (healthcare…

    Molina Healthcare (Rochester, NY)
    …is clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it ... provider), network management, credentialing, prior authorizations, fee schedules, and other business requirements critical to claim accuracy. Maintain audit… more
    Molina Healthcare (09/24/25)
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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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  • Data Entry Specialist

    MVP Health Care (Rochester, NY)
    …contact our Talent team at ###@mvphealthcare.com . **Job Details** **Job Family** ** Claims / Operations ** **Pay Type** **Hourly** **Hiring Min Rate** **20 USD** ... 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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  • Revenue Specialist

    Stony Brook University (East Setauket, NY)
    …day-to-day business functions including but not limited to: billing, claims analysis appeals, follow-up, financial assistance and customer service. **Duties of a ... Revenue Specialist **Position Summary** At Stony Brook Medicine, a...are not limited to:** + Prepare and submit hospital claims . Review denials. Investigate coding issue. Audits. + Follow-up… more
    Stony Brook University (10/03/25)
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  • Business Intelligence Specialist

    WMCHealth (Valhalla, NY)
    Business Intelligence Specialist - ONSITE Company: NorthEast Provider Solutions Inc. City/State: Valhalla, NY Category: Professional/Non-Clinical Department: ... Internal Applicant link Job Details: Job Summary: As a Business Intelligence Specialist within the Strategy and...and consistency. + Partner with Strategy, Enterprise Analytics, and Operations to understand key business questions and… more
    WMCHealth (09/12/25)
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  • Denials Recovery Specialist I

    UHS (Binghamton, NY)
    Position OverviewUnited Health Services (UHS) is seeking a detail-driven Denials Recovery Specialist to join our Revenue Cycle team. In this role, you will ... investigate, analyze, and resolve denied insurance claims -ensuring timely reimbursement and supporting the financial integrity of our organization. Your critical… more
    UHS (09/19/25)
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  • Pharmacy Revenue Cycle Specialist - Full…

    Mohawk Valley Health System (Utica, NY)
    Pharmacy Revenue Cycle Specialist - Full Time - Days Department: 340B CONTRACT PHARMACY Job Summary The Pharmacy Revenue Cycle Specialist supports comprehensive ... Pharmacy-related billing, charge integrity, and reimbursement operations across inpatient, outpatient retail, specialty, and infusion pharmacy services. Reporting to… more
    Mohawk Valley Health System (09/25/25)
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  • Specialist , Provider Network…

    Molina Healthcare (Rochester, NY)
    …on all claims and provider databases. Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider ... **JOB DESCRIPTION** **This role will have standard EST business hours.** **Job Summary** Provider Network Administration is...+ Experience in one or more of the following: Claims , Provider Services, Provider Network Operations , Hospital… more
    Molina Healthcare (08/14/25)
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  • Billing Specialist - Pharmacy Technician

    Independent Health (Buffalo, NY)
    …a culture that fosters growth, innovation and collaboration. **Overview** The Billing Specialist assists with the various activities of the pharmacy operations ... not requiring the professional judgment of the pharmacist. The Billing Specialist is primarily responsible for completing the billing of both pharmacy and medical … more
    Independent Health (09/10/25)
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  • Provider Contracting Specialist

    FlexStaff (Bronx, NY)
    …Contracting Specialist works closely with various key stakeholders, including business development, clinical, claims operations , compliance, and finance, ... **Req Number** 169759 FlexStaff is hiring a Provider Contract Specialist for one of our clients. The Provider Contracting Specialist is responsible for the… more
    FlexStaff (10/15/25)
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