• Medical Review Nurse (RN)

    Molina Healthcare (Buffalo, NY)
    …Looking for a RN with experience with appeals, claims review, and medical coding . **Job Summary** Provides support for medical claim and internal appeals review ... readmissions. + Validates member medical records and claims submitted/correct coding , to ensure appropriate reimbursement to providers. + Resolves escalated… more
    Molina Healthcare (10/18/25)
    - Related Jobs
  • Director, Clinical Documentation Improvement…

    Rochester Regional Health (Rochester, NY)
    …educational classes. + Maintains up-to-date knowledge of regulatory changes impacting coding requirements and ensures CDI staffs are appropriately educated. + ... for the CDI Team and other healthcare professionals/departments in the use of coding guidelines and proper documentation requirements as it relates to data quality… more
    Rochester Regional Health (10/04/25)
    - Related Jobs
  • Billing Rep

    ConnextCare (Oswego, NY)
    …billing charges with the chart note to make sure all charges match the coding guidelines and all procedures are billed correctly + Communicate questions in a task ... Must be able to use the CPT and/or CDT coding book + Act as a backup for the...Upgrade to a higher level from Billing Rep. to Specialist to Senior would depend on length of employment,… more
    ConnextCare (11/18/25)
    - Related Jobs
  • RN UM Clinical Appeals Nurse Remote

    Molina Healthcare (Buffalo, NY)
    …practice. * Experience demonstrating knowledge of ICD-9, Current Procedural Technology (CPT) coding and Healthcare Common Procedure Coding (HCPC). * Experience ... Qualifications** * Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare… more
    Molina Healthcare (11/14/25)
    - Related Jobs
  • Revenue Cycle Manager

    Oak Orchard Health (Brockport, NY)
    …with coding and billing, required. + Certified Medical Billing Specialist /Medical Coder highly preferred. Comprehensive Benefits: + Health / Dental /Vision ... within client assigned status buckets. Perform weekly audits to ensure proper billing/ coding on claims, provide reports to Chief Financial Officer and Leadership,… more
    Oak Orchard Health (10/14/25)
    - Related Jobs
  • Claims Representative

    CDPHP (Latham, NY)
    …the incumbent will utilize and interpret Claims Operations Policies and Procedures, coding methodologies, Plan contract language, riders, and schedules in order to ... and quality standards and adhering to prompt pay regulations. The specialist will address and resolve service-related issues including claim adjustment requests,… more
    CDPHP (11/12/25)
    - Related Jobs
  • Data Analyst I

    University of Rochester (Rochester, NY)
    …trauma registry. + Maintain all reference materials necessary for trauma registry, coding , and abstracting. + Research, evaluate and recommend changes in equipment ... Nurse, or Emergency Medical Technician-Paramedic Preferred + Completion of ICD-10 coding course Preferred + Completion of Association for the Advancement of… more
    University of Rochester (11/05/25)
    - Related Jobs
  • Lead Systems Architect

    City of New York (New York, NY)
    Job Description APPLICANTS MUST BE PERMANENT IN THE COMPUTER SPECIALIST CIVIL SERVICE TITLE OR BE REACHABLE WITH THE SCORE OF 100 ON THE OPEN COMPETITIVE COMPUTER ... SPECIALIST EXAM (# 1139) Under minimum direction of the...object-oriented Java systems. - Lead and conduct the of coding SQL stored procedures and designing SQL Server databases… more
    City of New York (11/08/25)
    - Related Jobs
  • Application Architect

    City of New York (New York, NY)
    Job Description APPLICANTS MUST BE PERMANENT IN THE COMPUTER SPECIALIST CIVIL SERVICE TITLE The Office of Revenue Management and Development (ORMD) is a major ... Strategic Enterprise Analysis & Development (SEAD) is recruiting for (1) one Computer Specialist (SW) II to function as the Application Architect who will: - Provide… more
    City of New York (11/12/25)
    - Related Jobs
  • Senior .Net Developer

    City of New York (New York, NY)
    …and maintaining agency applications. - Participates in developing and enforcing coding standards, security protocols, and quality assurance procedures. - Keeps ... or those who are already permanent in the Computer Specialist Software title. Please indicate in your cover letter...an exam or are already permanent in the Computer Specialist Software title. Applicants who filed for an exam… more
    City of New York (11/05/25)
    - Related Jobs