• Data Entry Specialist

    MVP Health Care (Rochester, NY)
    …+ Proficiency in Microsoft Word and Excel. + Familiarity with medical terminology and claims processing . + Curiosity to foster innovation and pave the way for ... virtual, in Schenectady or Rochester, NY + 1-2 years of data entry or claims experience preferred. High accuracy and attention to detail. + Strong data entry skills… more
    MVP Health Care (10/01/25)
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  • Pharmacy Coordinator

    Highmark Health (Albany, NY)
    …+ High school diploma or GED + Experience in pharmacy prescription claims processing /submission/payment. **Preferred** + Associate degree + Pharmacy technician ... completely in the appropriate systems. + Monitor member medication adherence through claims data analysis and other available resources. + Identify and resolve… more
    Highmark Health (09/19/25)
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  • Senior Analyst, Medical Economics (Vbc) - Remote

    Molina Healthcare (NY)
    …of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing , etc.) + Knowledge of healthcare financial terms ... executive decision-making + Mine and manage information from large data sources. + Analyze claims and other data sources to identify early signs of trends or other… more
    Molina Healthcare (08/31/25)
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  • Care Coordinator

    Brighton Health Plan Solutions, LLC (Westbury, NY)
    …employers and claimants in regard to claimants' workers' compensation cases. Provide claims processing for the Workers' Compensation and No-Fault lines of ... About The Role MagnaCare provides Utilization Review/ Case Management/ Medical Management/ Claims Review services to its clients. Care Coordinators facilitate care… more
    Brighton Health Plan Solutions, LLC (08/27/25)
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  • Sr Engineer, Applications- PowerBI

    Molina Healthcare (Yonkers, NY)
    …deliver analytics and reporting solutions that help track, measure, and optimize automated claims processing solutions. The role will leverage tools like Power ... reporting to track solution effectiveness and surface potential issues + Creating claims impact reporting to assess automation potential, issues or financial impact… more
    Molina Healthcare (08/27/25)
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  • Manager, Medical Economics (Medicaid) - REMOTE

    Molina Healthcare (Buffalo, NY)
    …of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing , etc.) + Knowledge of healthcare financial terms ... executive decision-making + Mine and manage information from large data sources. + Analyze claims and other data sources to identify early signs of trends or other… more
    Molina Healthcare (08/27/25)
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  • Team Lead - Adjustments and Recovery

    CVS Health (Albany, NY)
    …+ 2+ years medical claim rework/adjustment experience. + 2+ years medical claims processing experience. + Excellent verbal and written communication skills. ... on project teams + Experience conducting user acceptance testing (UAT) + DG claims system experience + Experience performing recovery tasks and/or processing … more
    CVS Health (09/26/25)
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  • Financial Assistant - Billing Specialist

    Lakeview Health Services (Geneva, NY)
    …supervision, is responsible for a variety of office/clerical tasks relating to claims processing ; contacting responsible parties to resolve past-due accounts; ... by batch in accordance with established protocol + Submit claims to 3rd party sources of payments + Post...funding continuity and stability + Perform prompt and accurate processing of all bank deposits and transfers + Post… more
    Lakeview Health Services (09/21/25)
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  • Credentialing Representative

    Highmark Health (Albany, NY)
    …Provider File systems. + Experience with the Customer Service inquiry system or claims processing concepts. **Knowledge, Skills and Abilities** + Good written ... by telephone or in writing to obtain additional information while processing their enrollment applications. + Screen incoming applications and paperwork for… more
    Highmark Health (09/06/25)
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  • Pharmacy Help Desk Representative

    Independent Health (Buffalo, NY)
    …daily basis. Assist in interpreting database information as it relates to pharmacy claims processing . + Assist with PBM implementation by identifying potential ... department with various data entry projects/information as they relate to pharmacy claims processing . C. Administrative Duties + Provide accurate and up-to-date… more
    Independent Health (08/29/25)
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