• Commercial Insurance Liaison

    UHS (Johnson City, NY)
    …and payer standards before submission, helping streamline approvals and reduce delays. At UHS, we believe every connection matters-including the one between clinical ... care and coverage. Primary Department, Division, or Unit: Patient Accounting, UHS Home Care Primary Work Shift: Day Regular Scheduled Weekly Hours: 40 Compensation… more
    UHS (06/29/25)
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  • Admission Coordinator

    Sodus Rehab & Nursing Center (Utica, NY)
    …Update all information in computer systems as it relates to the nursing home . Admissions Coordinator must conduct outreach to increase referrals for the Nursing ... Home . KEY ESSENTIAL FUNCTIONS: + . Responsible for coordination...concurrent review. + . Coordinate with Social Services and Medical Department to obtain clinical notes & social work… more
    Sodus Rehab & Nursing Center (06/24/25)
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  • Medicolegal Analyst (Law Dept) Lv2

    City of New York (New York, NY)
    …Compensation Division are responsible for all medically related issues for medical management of workers' compensation claims . Responsibilities include: Consult ... relates to the claimant's work injury and assist with medical case management of claims . Review and...compensation patients and aggressively negotiate rates for sub-acute and/or home care. Review independent medical examinations to… more
    City of New York (05/14/25)
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  • Medicaid Provider Hospital Reimbursement…

    Humana (Albany, NY)
    …agency + Intermediate Microsoft Access skills **Additional Information** This role is "remote/work at home " and can be based anywhere in the United States ... closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid… more
    Humana (07/29/25)
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  • Attorney Auditor

    Sedgwick (Rochester, NY)
    …any of the 50 United States are encouraged to apply. As an Attorney Auditor at Sedgwick, you'll have the opportunity to take on new challenges and help solve complex ... growth opportunities. + A diverse and comprehensive benefits offering including medical , dental vision, 401K and PTO. + Wellness benefits including wellness… more
    Sedgwick (07/09/25)
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  • Clinical Reviewer, Nurse - 9am -6pm PST

    Evolent (Albany, NY)
    …**Technical Requirements:** We require that all employees have the following technical capability at their home : High speed internet over 10 Mbps and, ... are performed within the RN/LVN/LPN scope of practice, under Medical Director direction, using independent nursing judgement and decision-making,...employees, the ability to plug in directly to the home internet router. These at - home more
    Evolent (08/01/25)
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  • Associate Director, Performance Analytics

    Evolent (Albany, NY)
    …and member-centric products. This role plays a critical part in both ** Medical Cost Management** and **Product Management** , leveraging advanced analytics to solve ... impactful decision-making that enhances organizational performance and patient outcomes. At Evolent, we prioritize work-life balance, flexibility, and autonomy. We… more
    Evolent (07/15/25)
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  • Regional Safety Superintendent

    Utilities Service, LLC (Albany, NY)
    …objectives of Safety Management + Observing and correcting unsafe acts and at -risk behavior + Evaluating General Foreperson knowledge of safety program + Identifying ... implement: + First Aid/CPR training + Lift School + Home Study Programs + Spanish documentation (when required) +...checks + Safety Management Process + Monitors and review claims and participate in claims management process.… more
    Utilities Service, LLC (06/25/25)
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  • Plan Advocate Support I

    NASCO (Albany, NY)
    …Skills, Abilities and Experience:** + General knowledge on NASCO's BlueCard, Claims , Membership and E-business product offerings. + General knowledge of NASCO ... ticket resolutions with closure. + Has working knowledge of at least 1 product or service offering + Ability...(eESM, ManageNow, ISM) or comparable **Working Conditions:** + Location: Home office / Remote + Travel: Occasional overnight travel… more
    NASCO (07/30/25)
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  • Director, Data & AI Architecture

    NASCO (Albany, NY)
    …with US Healthcare payer analytics use cases (eg, risk stratification, claims analytics, provider network optimization) + Certifications in cloud technologies (AWS ... business administration or a related field **Working Conditions:** + Remote/ Home Office + Well-lighted, heated and/or air conditioned indoor...adequate ventilation + Must be able to use equipment at workstation for up to 8 hours daily +… more
    NASCO (07/24/25)
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