• Staff Assistant 2 - Radiology

    SUNY Upstate Medical University (Syracuse, NY)
    …and recommending and coordinating corrective actions. Review orders for appropriate clinical indications and provide ICD-10 coding . Monitor new ... insurance demographic information and medical necessity pertaining to documentation and coding . Will interact with referring physicians, patients, hospital and MSG… more
    SUNY Upstate Medical University (11/24/25)
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  • Senior Director, Patient Financial Services…

    Mount Sinai Health System (New York, NY)
    …touches, aged AR trends and billing lags. + Collaborate with department such as coding , IT, clinical service areas and appeals to ensure seamless end-to-end ... across departments (eg, DTP, Human Resources, Managed Care, Finance, and clinical departments) + Collaborates with finance, managed care and DTP contributors… more
    Mount Sinai Health System (11/11/25)
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  • Endoscopy Procedural Scheduler

    SUNY Upstate Medical University (Syracuse, NY)
    …all endoscopy and procedural procedures and assures that all of the appropriate clinical , equipment and insurance coding information is collected for the surgery ... schedule. Scheduler receives requests to schedule procedures from physician offices and schedules the procedure according to established guidelines and policies. Scheduler provides accurate information so that all departments may view daily, and maintains open… more
    SUNY Upstate Medical University (11/06/25)
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  • RN Clinical Appeals Nurse Remote

    Molina Healthcare (Rochester, NY)
    JOB DESCRIPTION **Job Summary** The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests are ... regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Assesses appropriateness of services, length of stay and… more
    Molina Healthcare (01/02/26)
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  • Medical Director - Medicaid (remote)

    Humana (Albany, NY)
    …these may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and ... and work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal… more
    Humana (01/01/26)
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  • Medical Director-Payment Integrity

    Humana (Albany, NY)
    …discussions with an external provider. Some roles include an overview of coding practices and clinical documentation, dispute/grievance and appeals processes, ... and work is assisted by diverse resources, which may include national clinical guidelines, CMS policies and determinations, clinical reference materials,… more
    Humana (12/11/25)
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  • Medical Director - IP Claims Management

    Humana (Albany, NY)
    …may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, dispute, grievance, and appeals processes, ... and work is assisted by diverse resources, which may include national clinical guidelines, CMS and state policies and determinations, clinical reference… more
    Humana (12/11/25)
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  • RN MDS Supervisor- Clinical Reimbursement…

    Catholic Health Services (Smithtown, NY)
    …- to every resident and patient, every time. Job Details Summary: The Clinical Reimbursement and Quality Management plays a vital role in ensuring accurate ... care and ensuring compliance with regulatory standards. Key Responsibilities: Clinical Reimbursement: + Documentation: Review and analyze resident documentation to… more
    Catholic Health Services (12/24/25)
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  • Lead Clinical Documentation Specialist

    BronxCare Health System (Bronx, NY)
    Overview The Clinical Documentation Specialist will work with Senior Director in physician education regarding documentation that meets severity of illness/intensity ... hospital top DRG's to insure that documentation is optimal and meets coding clinic guidelines in order insure optimal hospital reimbursement. Prepares and presents… more
    BronxCare Health System (11/25/25)
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  • Clinical Investigator

    MVP Health Care (Tarrytown, NY)
    …innovative thinking and continuous improvement. To achieve this, we're looking for a ** Clinical Investigator** to join #TeamMVP. This is the opportunity for you if ... professional investigation experience involving economic or insurance related matters. + A clinical investigator must have in addition to the above requirements: A… more
    MVP Health Care (12/02/25)
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