• Medical Claim Review Nurse (RN)

    Molina Healthcare (Rochester, NY)
    …for a RN with experience with appeals , claims review, and medical coding . **Job Summary** Utilizing clinical knowledge and experience, responsible for review ... resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries/ Appeals . + Provides training and support to clinical … more
    Molina Healthcare (09/06/25)
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  • Clinical Documentation Integrity Manager-…

    Garnet Health (Middletown, NY)
    …Garnet Health Medical Center. Responsibilities Under the direction of The Administrator, Coding & Clinical Documentation Improvement and Patient Access, the ... knowledge, required* Exceptional ability to communicate effectively with physicians and other clinical professional staff.* Knowledge of DRG and Coding appeal… more
    Garnet Health (09/05/25)
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  • Clinical Denials Specialist

    UHS (Binghamton, NY)
    Position OverviewUnited Health Services (UHS) is seeking a proactive and analytical Clinical Denials Specialist to join our Revenue Cycle team. In this vital role, ... you will focus on the prevention and resolution of clinical claim denials by analyzing denial patterns, investigating and appealing denied claims, and collaborating… more
    UHS (09/09/25)
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  • RN - MDS Coordinator

    Elderwood (Cheektowaga, NY)
    Salary $38 - $49.50 per hour Overview Are you a Registered Nurse (RN) with Medicare experience? Do you consider yourself an expert in assessment and reimbursement ... of Benefits Program + Increased Tuition Reimbursement Program for Clinical Tracks + Shift Differentials + Full Benefits Package...for pre and post-pay record reviews, ADR requests and appeals processes. + Manages NYS RUGs III case mix… more
    Elderwood (10/04/25)
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