• ACA/Medicare Risk Adjustment Analyst Sr.

    Baylor Scott & White Health (Albany, NY)
    …appropriate statistical trend analysis. + Performs root cause analysis of claims /encounters processing and submission issues; develops recommendations based on ... and outbound encounter process. + Monitors and oversees the end-to-end claims encounter management workflow. + Identifies and interprets encounter data, submission… more
    Baylor Scott & White Health (10/03/25)
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  • Investigator, Coding Special Investigative Unit…

    Molina Healthcare (NY)
    …years of experience working in the group health business preferred, particularly within claims processing or operations. + A demonstrated working knowledge of ... etc.) + Experience with UNET, Comet, Macess/CSP, or other similar claims processing systems. + Demonstrated ability to use MS Excel/Access platforms working… more
    Molina Healthcare (11/20/25)
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  • Senior Medical Biller, Full-Time, 100% On-Site

    FlexStaff (New York, NY)
    …time off. In this role you will be ensuring timely and accurate claims processing , managing denials, and assisting with billing-related reporting and audits. ... office. Requirements: * 5+ years of experience in medical billing and claims processing , and insurance follow-up. * Certification in medical billing and coding… more
    FlexStaff (09/05/25)
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  • Pharmacy Systems Coordinator

    Independent Health (Buffalo, NY)
    …limited to reviewing reports and resolving any associated issues. Monitor and validate claims for processing accuracy. Participate as the Detective of the Day ... new pharmacies, pharmacy pricing and QA-ing client pricing. Complete processing of file loads needed for claims ...Complete processing of file loads needed for claims management. Assist with any ad-hoc projects as needed.… more
    Independent Health (11/03/25)
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  • Medical Billing Specialist

    Robert Half Accountemps (Rochester, NY)
    …will play a key role in managing billing operations, ensuring accuracy in claims processing , and maintaining compliance with healthcare regulations. This is an ... to providing high-quality service. Responsibilities: * Process and submit medical claims to insurance providers, ensuring accuracy and adherence to guidelines. *… more
    Robert Half Accountemps (10/25/25)
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  • Sr. Provider Reimbursement Professional Certified…

    Humana (Albany, NY)
    …certification from the AAPC and/or AHIMA) + Extensive knowledge of medical claims processing and familiarity with reimbursement methodologies, ICD, CPT, and ... Medical Coverage Policies and Claims Payment Policies + CAS claims processing experience + Experience in data analysis and trend monitoring **Work-At-Home… more
    Humana (11/21/25)
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  • Dental Practice Manager

    OLV Human Services (Lackawanna, NY)
    …standards. A critical part of the role involves evaluating insurance coverage, managing claims processing , and ensuring all aspects of patient care are ... with Finance to ensure patient charts are updated appropriately, if claims are denied/rejected. * Implement and maintain systems for insurance verification,… more
    OLV Human Services (11/19/25)
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  • Assistant Supervisor- Benefits Examiner Level 2

    City of New York (New York, NY)
    …of medical consultation appropriate to the circumstances of the cases. Reviews claims for processing voluntary awards of workers' compensation benefits. Trains ... 5141. Under direct supervision, receives and processes incoming workers' compensation claims . Performs tasks such as the following: Reviews accident reports and… more
    City of New York (09/05/25)
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  • Senior Manager - General Law I (Toll Group)

    MTA (New York, NY)
    …assists clerical/administrative staff in handling subpoenas, service of process, claims handling/ processing , bankruptcy searches of toll violators, scheduling ... toll revenue, as well as oversees the intake and processing of legal papers served on the TBTA, reviewing...Insurance Management, and other MTA Departments and subsidiaries in claims /litigation by contractors and third parties. + Assists relevant… more
    MTA (10/16/25)
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  • Total Loss Claim Representative

    Travelers Insurance Company (Albany, NY)
    …us most. As a Claim Rep, you will be responsible for managing, evaluating, and processing claims in a timely and accurate manner. In this detail-oriented and ... guides our customers back to stability. At Travelers, our Claims Organization isn't just a department; it's the beating...role, you will work closely with insureds to ensure claims are resolved efficiently while maintaining a high level… more
    Travelers Insurance Company (11/21/25)
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