• Specialist , Appeals & Grievances

    Molina Healthcare (Buffalo, NY)
    …for reviewing and resolving member and provider complaints and communicating resolution to members and provider (or authorized representatives) in accordance with ... Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for the comprehensive research and resolution of the appeals, dispute, grievances, and/or complaints from… more
    Molina Healthcare (08/01/25)
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  • Clin Tech Specialist (Blood Bank)

    Albany Medical Center (Albany, NY)
    …Salary Range: $71,612.39 - $110,999.20 The Clinical Technical Specialist is a technologist (clinical laboratory/cytology/histology) and performs procedures/tests ... independent judgement and responsibility with minimal supervision. The Technical Specialist has expertise in laboratory medicine in the specialty/subspecialty area… more
    Albany Medical Center (06/10/25)
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  • Specialist , Configuration Oversight

    Molina Healthcare (NY)
    …clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains ... audits and communicates with Core Operations Functional Business Partners to ensure resolution within 30 days of error issuance. * Evaluates the adjudication of… more
    Molina Healthcare (07/18/25)
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  • Billing & Reimbursement Specialist

    Rochester Regional Health (Rochester, NY)
    …and Reimbursement Specialist is responsible for timely processing of medical claims for DRUGSCAN. RESPONSIBILITIES + Process current and aged denials to improve ... Job Title: Billing & Reimbursement Specialist Department: Billing Location: Hybrid; Horsham, PA Hours...processing status and clarification regarding un-responded or partially responded claims . + Analyze and report trends based on data… more
    Rochester Regional Health (07/19/25)
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  • Remote Medical Staff Services Health Care…

    Mount Sinai Health System (New York, NY)
    …+ Interaction with plan representatives regarding enrollment audits; problems and claims resolution ; identify fee schedule issues; and addressing potential ... **Job Description** **Remote Medical Staff Services Health Care Specialist (Delegation/Enrollment)** The Medical Staff Services Health Care Specialist is… more
    Mount Sinai Health System (07/17/25)
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  • Inpatient Clinical & Coding Specialist…

    Independent Health (Buffalo, NY)
    …fosters growth, innovation and collaboration. **Overview** The Clinical & Coding Specialist -Senior will be responsible for reviewing coding and clinical decisions on ... share knowledge and audit tips across the team. The Clinical & Coding Specialist -Senior will support the leadership in Hospital Audit in accomplishing all aspects of… more
    Independent Health (07/15/25)
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  • Revenue Coding Specialist - Revenue Cycle

    Arnot Health (Elmira, NY)
    …(LCDs, NCDs, NYS insurance laws, payer policies) + Assist in claim edit resolution to ensure compliant, clean claims are submitted + Maintain proficiency ... Job Description We're looking for a Revenue Coding Specialist passionate about accuracy, compliance, and process improvement...charge optimization across our health system. The Revenue Coding Specialist plays a vital role in ensuring compliant and… more
    Arnot Health (07/15/25)
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  • Specialist , Appeals & Grievances

    Molina Healthcare (Yonkers, NY)
    …and Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for the comprehensive research and resolution of Provider No Surprises Act cases to ensure that internal ... and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine...years operational managed care experience (call center, appeals or claims environment). + Health claims processing background,… more
    Molina Healthcare (08/01/25)
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  • Accounts Receivable Specialist

    Glens Falls Hospital (Glens Falls, NY)
    …as payer meetings, payer websites, and provider representatives * Promptly resolve denied claims with a goal of one touch resolution * Identify trends/errors ... Come join our team of medical billing experts as the Accounts Receivable Specialist ! This is an exciting opportunity that can further develop your skills in… more
    Glens Falls Hospital (07/02/25)
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  • Billing Specialist - Rheumatology @…

    SUNY Upstate Medical University (Syracuse, NY)
    …inbound inquires related to prior authorizations and assists billing group on insurance claims . Completes outbound calls to payors and clinics to assist with prior ... due to insurance policy changes. + Escalates issues to supervisor for resolution , as deemed necessary. + Reviews and complies with all applicable Department… more
    SUNY Upstate Medical University (07/07/25)
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