• Specialist , Appeals & Grievances…

    Molina Healthcare (Albany, NY)
    …of benefits, subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge ... and requirements established by the Centers for Medicare and Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for the comprehensive research and resolution… more
    Molina Healthcare (09/25/25)
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  • Eligibility Specialist

    Constructive Partnerships Unlimited (Manhattan, NY)
    Eligibility Specialist Type of Position Full time Search Location(s) Manhattan, NY Apply Now ... (https://phe.tbe.taleo.net/phe03/ats/careers/v2/applyRequisition?org=CPOFNYS&cws=37&rid=6455) Job Brief Responsible for preparing Medicaid and Social Security Administration (SSA) recertifications; completing representative… more
    Constructive Partnerships Unlimited (08/08/25)
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  • Eligibility Verification Specialist

    City of New York (New York, NY)
    …is recruiting one (1) Principal Administrative Associate II to function as an Eligibility Verification Specialist in its Eligibility Verification Division, ... of Revenue Management and Development (ORMD)/The Bureau of Case Integrity & Eligibility Verification's (BCIEV) mission is to identify system enhancements to improve… more
    City of New York (08/02/25)
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  • Senior Billing Specialist

    Access: Supports For Living (Middletown, NY)
    …on a collaborative team. + Knowledge of Medical Insurance programs such as Medicaid , Medicare and Dual eligibility benefits establishment. + Experience with ... Senior Billing Specialist Location: Middletown, NY, United StatesDate Posted: Jul...throughout the revenue cycle. This individual manages the electronic claims process, including accurate and timely claim batch creation,… more
    Access: Supports For Living (09/04/25)
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  • Provider Appeals & Grievances Specialist

    Cognizant (Albany, NY)
    …with a healthcare plan, not on behalf of provider or provider's office) Medicaid insurance customer service or claims processing Medicaid /Medicare Insurance ... **Provider Appeals & Grievances Specialist ** (remote) This is a remote position open...the desire to further their abilities and knowledge of Medicaid medical insurance processes as they will be responsible… more
    Cognizant (10/07/25)
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  • Senior Healthcare Program Specialist

    Staffing Solutions Organization (Albany, NY)
    …Insurance (TPHI) and make the necessary determination regarding when and how to update eligibility and claims systems. + Take the appropriate actions regarding ... clients and the people they serve. **Senior Healthcare Program Specialist (Level 2 or 3) - Albany, NY** **Division...(Level 2 or 3) - Albany, NY** **Division of Eligibility & Marketplace Integration (DEMI)** **Bureau of Third-Party Health… more
    Staffing Solutions Organization (07/23/25)
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  • Patient Access Specialist

    Planned Parenthood of Greater New York (Schenectady, NY)
    POSITION SUMMARY The Patient Access Specialist is an integral member of the Patient Access Optimization Team, responsible for ensuring an exceptional patient ... Reg Review WQ for errors or missing information. . Corrects errors and resubmits claims in PPGNY Reg Review WQ. . Work with patients and internal departments to… more
    Planned Parenthood of Greater New York (09/25/25)
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  • Registered Nurse - Clinical Appeals & Denials…

    Cognizant (Albany, NY)
    …accounts. . Maintain working knowledge of applicable health insurers' internal claims , appeals, and retro-authorization as well as timely filing deadlines and ... based on the review of clinical documentation in accordance with Medicare, Medicaid , and third-party guidelines. . Effectively document and log claims /appeals… more
    Cognizant (10/09/25)
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  • Representative II, Accounts Receivable

    Cardinal Health (Albany, NY)
    …skills and prioritizes getting the right things done. **The Accounts Receivable Specialist is responsible for processing insurance claims and billing. They ... and support from AR & Billing leadership teams.** **_Responsibilities_** + Processes claims : investigates insurance claims ; and properly resolves by follow-up &… more
    Cardinal Health (10/10/25)
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