• Coding Auditor Educator

    Highmark Health (Albany, NY)
    …staff, physicians and appropriate individuals. (20%) + Validates the ICD-CM, ICD-PCS, CPT and HCPCS Level II code and modifier systems, missed secondary diagnoses ... appropriate payor specific groups consisting of ICD-CM ICD-PCS and CPT codes for diagnoses and procedures and calculates the...processes as it relates to the DRG/APC and other clinical data quality management factors. With technical direction and… more
    Highmark Health (08/08/25)
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  • Revenue Integrity Analyst

    WMCHealth (Valhalla, NY)
    …realized + Researches and communicates appropriate treatment of charges to clinical managers, CDM Specialist (coordinator), other customers. + Participates ... appealed in a timely manner. Coordinating appeal discussions with clinical & third party payors. + Develop, Implement and...liaison with CDM software companies to evaluate and validate CPT and revenue codes and related coverage issues. +… more
    WMCHealth (06/27/25)
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  • Experienced Outpatient Medical Record Coder

    Stony Brook University (Commack, NY)
    …line. **Job Number:** 2502416 **Official Job Title:** : TH Medical Records Specialist **Job Field** : Administrative & Professional (non- Clinical ) **Primary ... assigning accurate codes from the current version of coding systems including ICD-10 CM/PCS, CPT and HCPCS codes. **Duties of a Coder may include the following but… more
    Stony Brook University (06/12/25)
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  • Senior Coder (Inpatient/Ambulatory)

    Northwell Health (Lake Success, NY)
    …2.Applies understanding of basic anatomy and physiology to interpret clinical documentation and identify applicable codes. 3.Utilizes resources and reference ... Coding Guidelines (OCG), AHA Coding Clinic, Center for Medicare Services and CPT Assistant) to identify appropriate codes and reference code applicability, rules and… more
    Northwell Health (08/08/25)
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  • Senior Advisor, System Administrator, Revenue…

    Cardinal Health (Albany, NY)
    …Revenue Cycle Management manages a team focused on a series of clinical and administrative processes that healthcare providers utilize to capture, bill, and ... system, including the accurate loading and mapping of fee schedules, effective CPT code management, the upkeep of the ICD-10 diagnosis directory, and insurance… more
    Cardinal Health (08/08/25)
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  • Referral & Prior Auth Rep III

    University of Rochester (Rochester, NY)
    …GENERAL PURPOSE Serves as the patient referral and prior authorization specialist , with oversight of data and compliance to enterprise standards and ... referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non- clinical staff, identifying barriers to appointment… more
    University of Rochester (08/07/25)
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  • Nurse Practitioner (NP) - PRN

    STG International (Auburn, NY)
    …SUMMARY: The general duty of the Nurse Practitioner is to provide professional clinical services under the direction of the Community Based Outpatient Clinic (CBOC) ... patients under a limited scope of Current Procedural Terminology ( CPT ) codes and within his/her skills and training. *...ie, walk in patients. * Provides a model for clinical practice within the clinic setting. * Sets up… more
    STG International (07/10/25)
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  • Nurse Practitioner (NP)

    STG International (Kingston, NY)
    …SUMMARY: The general duty of the Nurse Practitioner is to provide professional clinical services under the direction of the Community Based Outpatient Clinic (CBOC) ... patients under a limited scope of Current Procedural Terminology ( CPT ) codes and within his/her skills and training. +...ie, walk in patients. + Provides a model for clinical practice within the clinic setting. + Sets up… more
    STG International (07/09/25)
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  • Advanced Registered Nurse Practitioner (APRN)/…

    STG International (Plattsburgh, NY)
    …Nurse Practitioner (NP) or Physician Assistant (PA) is to provide professional clinical services under the direction of the Community Based Outpatient Clinic (CBOC) ... patients under a limited scope of Current Procedural Terminology ( CPT ) codes and within his/her skills and training. +...ie, walk in patients. + Provides a model for clinical practice within the clinic setting. + Sets up… more
    STG International (08/08/25)
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  • Sr Analyst, Scope Management - Healthcare

    Evolent (Albany, NY)
    …financial scope within Evolent Specialty Services. Reporting to the Director, Clinical Informatics, this role is responsible for acquiring, synthesizing, and ... (UM) agreements. This important work is achieved through collaboration across the clinical , operations, product and technical teams. **What You Will Be Doing:** This… more
    Evolent (07/18/25)
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