• Incident Management Investigator

    Constructive Partnerships Unlimited (Manhattan, NY)
    …Incident Management Investigator works closely with the Incident Management Investigator Specialist I (IMIS-I) and Incident Management Investigator Specialist II ... regulations. POSITION DUTIES: 1. Works closely with the Incident Management Investigator Specialist I and II. 2. Participates in weekly group and individual… more
    Constructive Partnerships Unlimited (11/26/25)
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  • Collections & Denials Management Representative

    Rochester Regional Health (Rochester, NY)
    SUMMARY The C & D specialist is responsible for reviewing accounts which have been denied or underpaid by third party payers and to resolve the issues resulting in ... denial/underpayment and to formally appeal. The specialist will conduct comprehensive reviews of clinical documentation to determine if an appeal is warranted.… more
    Rochester Regional Health (11/21/25)
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  • Group Processing Worker

    City of New York (New York, NY)
    Job Description APPLICANTS MUST BE PERMANENT IN THE ELIGIBILITY SPECIALIST CIVIL SERVICE TITLE. The DSS Accountability Office (DSS-AO) is responsible for protecting ... act on behalf of the Bureau of Fraud Investigation, Liens and Recovery, Claims and Collections and the Assistance Reimbursement Unit. Their staff review cases,… more
    City of New York (11/05/25)
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  • RN UM Clinical Appeals Nurse Remote

    Molina Healthcare (Buffalo, NY)
    …likelihood of a formal appeal being submitted. * Reevaluates medical claims and associated records independently by applying advanced clinical knowledge, knowledge ... specific programs supported by the plan such as utilization review, medical claims review, long-term services and supports (LTSS), or other specific program… more
    Molina Healthcare (11/14/25)
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  • Project Officer II Construction Manager

    WSP USA (New York, NY)
    …and commit the SCA's resources on such change orders + Review contractors claims or disputed work and advise senior management as to appropriate action. + ... and project documentation necessary for adjudicating or denying such claims . + Visit various job sites as required in...of full time, progressively responsible work as a technical specialist in one or more construction and design related… more
    WSP USA (10/30/25)
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  • Employee Benefits Assistant

    Catholic Charities of the Dioscese of Albany (Albany, NY)
    …through: + Assist employees in the benefits program enrollment and benefit claims processes + Maintain changes to the employee benefit platforms including employee ... salary adjustments and benefit eligibility status; Assist the Employee Benefits Specialist with maintenance of the pension platform + Facilitate the resolution… more
    Catholic Charities of the Dioscese of Albany (10/21/25)
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  • Inventory Facilitator

    Lactalis American Group Inc. (Walton, NY)
    …part of the Lactalis family of companies, is currently hiring an Inventory Specialist based in Walton, NY. From yourPASSIONto ours Flexible and agile, ideal ... ingredients, including issuing of ticketing and adjusting inventory. . Manage claim activities for shipment damages, discrepancies, and customer refusals, and… more
    Lactalis American Group Inc. (11/20/25)
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  • Coding Educator

    Stony Brook University (Commack, NY)
    …+ Work in collaboration with the Patient Financial Services Department on claim corrections. + Special projects assignments related to coding. + Code, abstract ... Number:** 2500556 **Official Job Title:** : TH Medical Records Senior Specialist **Job Field** : Finance **Primary Location** : US-NY-Commack **Department/Hiring… more
    Stony Brook University (11/20/25)
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  • Medical Records Coder IV, Lead

    University of Rochester (Rochester, NY)
    …Understands Coding workflows for abstract coding, resolving coding charge review and claim edits, and resolving coding denials. 25% Identifies and escalates coding ... Administrator (RHIA); (Registered Health Information Technician); RHIT or Certified Coding Specialist (CCS); CPC. Knowledge of ICD-9CM and ICD-10CM required -… more
    University of Rochester (11/06/25)
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  • Referral & Prior Auth Rep III

    University of Rochester (Rochester, NY)
    …functionality required for testing and services ordered by referred to specialist includes, preparing and providing multiple, complex details to insurance or ... requests, necessary and appropriate medical terminology to use in order for claim to be approved, previous treatments that are necessary to report, appropriate… more
    University of Rochester (10/16/25)
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