• Pharmacy Coordinator

    Highmark Health (Albany, NY)
    …+ High school diploma or GED + Experience in pharmacy prescription claims processing /submission/payment. **Preferred** + Associate degree + Pharmacy technician ... inquiries concerning oral, injectable and infusion medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly… more
    Highmark Health (12/18/25)
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  • Patient Billing Supervisor

    Albany Medical Center (Albany, NY)
    …all payor appeals for claim denied erroneously Validate timely resolution of claim errors Validate timely and accurate refund processing Daily monitoring of ... follow up on all outstanding claims Validate timely submission of...all third party payor and federal and state government claim submission regulation Monthly review of chargemaster CPT, HCPCS… more
    Albany Medical Center (11/03/25)
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  • Senior QNXT Analyst - Contract Configuration

    Molina Healthcare (Yonkers, NY)
    …payment methodology & processing is essential + Understanding on hospital claims processing and configuration works + Medicare fee schedule knowledge is ... maintain contract, benefit or reference table information into the claim payment system and other applicable systems. + Participates...**Required Experience** 5-7 years in SQL, Medicare, Networx, QNXT, claims processing and hospital claims … more
    Molina Healthcare (12/31/25)
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  • Program Manager, Health Plan Payment Integrity…

    Molina Healthcare (Rochester, NY)
    …and test assumptions through data, and leads with contextual knowledge of claims processing , provider contracts, and operational realities. * Creates succinct ... all payment integrity (PI) solutions. * Independently leads efforts to improve claim payment accuracy, claim referrals, adjustment analysis and financial… more
    Molina Healthcare (01/10/26)
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  • Lead Networx Analyst, Contract Configuration Info…

    Molina Healthcare (Syracuse, NY)
    …Networx. + Experience with QNXT is preferred. + Advanced experience using a claims processing system. + Advanced experienced verifying documentation related to ... * Applies experience and knowledge to research and resolve claim /encounter issues and pended claims , and updates...updates/changes within a claims processing system. + Advanced experience validating… more
    Molina Healthcare (12/26/25)
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  • Biller

    Charles B. Wang Community Health Center (Queens, NY)
    …+ Maintain record of claims & payments + Maintain and report monthly statistics + Monitor denied claims processing + Perform other duties as assigned ... The Biller ensures accurate processing of medical claims using the...improving the overall patient experience. Responsibilities : + Handle claims : filing claim forms and posting payments… more
    Charles B. Wang Community Health Center (01/13/26)
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  • Benefits Specialist

    Richmond Community Services (Mount Kisco, NY)
    …& Compliance Tasks: You will ensure all deadlines are met by processing invoices, managing claims , submitting reports, and handling any unemployment ... medical, dental, life, and disability benefits. This includes calculating and processing monthly premiums, handling invoices, and generating reports for various… more
    Richmond Community Services (12/12/25)
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  • Accounts Receivable, Customer Service Operations

    Cardinal Health (Albany, NY)
    …reviewing, and transmitting claims using billing software including electronic and paper claim processing + Following up on unpaid claims within standard ... for verifying patient insurance and benefits, preparing and submitting claims to payers, correcting rejected claims , following...and submitting claims to payers, correcting rejected claims , following up on unpaid and denied claims… more
    Cardinal Health (01/03/26)
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  • Payment Integrity DRG Coding & Clinical Validation…

    Excellus BlueCross BlueShield (Rochester, NY)
    …. Ensures accurate payment by independently utilizing DRG grouper, encoder, and claims processing platform. . Manages case volumes and review/audit schedules, ... business analysis. . Intermediate knowledge of PC, software, auditing tools and claims processing systems. Level II (in addition to Level I Qualifications) .… more
    Excellus BlueCross BlueShield (10/23/25)
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  • Billing Specialist, Payment Poster

    Excelsior Orthopaedics Group (Amherst, NY)
    …will be responsible for processing the full lifecycle of medical claims -from charge entry and claim submission to payment posting, denial management, ... team focused, service driven, accountable, and innovative every day. + Track claim status using payer portals and billing software; investigate and resolve… more
    Excelsior Orthopaedics Group (01/14/26)
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