• Risk Adjustment Coding Specialist (Remote in New…

    CDPHP (Latham, NY)
    …information required. + Chronic Conditions knowledge preferred. + Experience in claims adjudication, billing and enrollment systems, product or pricing is preferred. ... expression, transgender status, age, national origin, marital status, citizenship, disability , criminal record, genetic information, predisposition or carrier status,… more
    CDPHP (08/27/25)
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  • Negotiator Analyst (Level I)

    CVS Health (Albany, NY)
    …Summary** The Negotiator Analyst is responsible for negotiating out-of-network (OON) medical claims valued at $10,000 and above. This role involves learning the ... all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit… more
    CVS Health (08/27/25)
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  • Remote Customer Service Representative

    Pearl Interactive Network (Albany, NY)
    …+ Navigate pre-scripted responses, read them verbatim to provide basic and claims -specific information, and ensure callers receive accurate details. + Perform other ... This is not an exhaustive list of all duties and responsibilities. Pearl management reserves the right to amend and change responsibilities to meet business and… more
    Pearl Interactive Network (08/27/25)
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  • Senior Customer Service Representative

    CVS Health (Albany, NY)
    …routine nature. + Handle incoming calls from members and providers regarding claims status, benefits and eligibility, PPO participation, etc + Maintain department ... all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit… more
    CVS Health (08/27/25)
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  • Accounts Receivable - Biller - Full Time - Days

    Mohawk Valley Health System (Utica, NY)
    …and uses them as a contact when necessary to resolve outstanding issue on claims . + Determines whether payment from insurance billed is accurate, based on DRG, ... thorough knowledge of rates for specific payor responsibility and advises management of any trends regarding inappropriate payments. + Maintains account receivables… more
    Mohawk Valley Health System (08/27/25)
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  • Servicing Representative

    Independent Health (Buffalo, NY)
    …and ability to utilize multiple system tools simultaneously. + Strong organizational/time management skills + Proven examples of displaying the PBD values: Trusted ... receive and effectively resolve written inquiries from members regarding claims , benefits, eligibility, reimbursement and participating providers. + Knowledge of… more
    Independent Health (08/26/25)
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  • Business Office Coordinator

    Elderwood (North Creek, NY)
    …Complete month-end close, prepare financial reports, and support year-end audits + Submit claims and follow through the AR and reimbursement cycle to ensure accurate ... under the direction of the Sr. Director of Revenue Cycle Management Qualifications + Minimum of two years previous Billing/Accounts Receivable experience… more
    Elderwood (08/26/25)
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  • Senior Analyst, Special Investigative Unit

    CVS Health (Albany, NY)
    …abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants and customers. + Researches and ... all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit… more
    CVS Health (08/24/25)
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  • Payment Fellow

    City of New York (New York, NY)
    …The work of DFS includes managing the ACS budget; submission of monthly claims for revenue; processing of payments to provider agencies and vendors; monitoring the ... met Duties are but not limit to the below - Perform administrative and management work associated with program goals - Maintain calendar of events that are related… more
    City of New York (08/24/25)
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  • Washington National Tax - Controversy Manager

    Deloitte (Williamsville, NY)
    …Revenue Service ("IRS") and litigation settlement, interest reviews, and IRS refund claims . + Assist clients and Deloitte engagement teams with federal interest and ... and business approval: + Licensed attorney + Enrolled Agent + Project Management Professional (PMP) + Chartered Financial Advisor (CFA) Preferred: + Bachelor's… more
    Deloitte (08/21/25)
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