• Assistant Director, Revenue Cycle

    CenterLight Health System (NY)
    …+ Coordinate with healthcare providers, practice managers, and coders to submit claims appropriately and timely. + Audit billing and collection procedures ... execution of enterprise-wide (CenterLight and its associated entities including C2Q Health Solutions, and Team Care Medical) billing and revenue maximization… more
    CenterLight Health System (04/15/25)
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  • Investigator

    Highmark Health (Albany, NY)
    …for proactive and investigative purposes to comply with internal audit and regulatory requirements. **ESSENTIAL RESPONSIBILITIES** + Performs investigations into ... Credentialing or Medical Review Committee. + Engages in delivery of audit results and overpayment negotiations.Responsible for recovery/ savings of misappropriated… more
    Highmark Health (05/08/25)
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  • Remote Accommodations Clinical Specialist-…

    Sedgwick (Albany, NY)
    …United States. **PRIMARY PURPOSE** : Performs standard clinical evaluations on claims that require additional review based on medical condition, client requirement, ... FUNCTIONS and RESPONSIBILITIES** + Consults on and evaluates complex claims to determine objective, quantifiable, medically supported work restrictions/accommodations.… more
    Sedgwick (05/23/25)
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  • Claim Preparation - Business Intruption - Forensic…

    AON (New York, NY)
    …What the day will look like As respects property damage and business interruption claims + Review, audit and analyze accounting books and records, financial ... sick leave laws, short-term disability and optional long-term disability, health savings account, health care and dependent...look like As respects property damage and business interruption claims + Review, audit and analyze accounting… more
    AON (05/13/25)
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  • Workforce Absence Team Lead

    Sedgwick (Albany, NY)
    …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... operations of multiple teams of examiners and technical staff for disability claims for clients; to monitor colleagues' workload, provide training, and monitor… more
    Sedgwick (05/20/25)
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  • Internal Auditor 1, or Trainee 1 / Trainee 2

    New York State Civil Service (Albany, NY)
    …Building - Core 1 City Albany State NY Zip Code 12239 Duties Description Audit and Risk Management is responsible for administering a comprehensive audit and ... role in ensuring the success of these modernization efforts. Audit and Risk Management performs audits of both the...Department's operations and the $14 billion New York State Health Insurance Program (NYSHIP). This position will focus on… more
    New York State Civil Service (06/06/25)
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  • Accounts Receivable Coordinator

    Independent Health (Buffalo, NY)
    …include continuous review of the accounts receivable aging report and ensuring all open claims are paid in a timely fashion. The coordinator will analyze data to ... payables or business to business account servicing required. Pharmacy and pharmaceutical claims knowledge preferred. + Experience working with online claims … more
    Independent Health (06/05/25)
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  • Collections and Eligibility Specialist - Clinic

    YAI (Manhattan, NY)
    …Functions & Responsibilities + Reviews and interprets patient eligibility and claims data from various sources (explanation of benefits, remittance statements, ... collections reports, etc.) to assess the correctness of claims submitted for processing, identifying and communicating discrepancies, issues and/or missing… more
    YAI (05/23/25)
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  • Reinsurance Transactional Auditor

    Axis (New York, NY)
    …Accuracy and Data Integrity** + Verifies the accuracy of reported premiums, claims , and reserves. + Identifies discrepancies in ceded premium calculations or loss ... with treaty terms and regulatory requirements. + Review reinsurance premiums, claims , and recoverable for accuracy and completeness. + Collaborate with underwriters,… more
    Axis (05/19/25)
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  • Risk Adjustment Coding Specialist-Excellus Fully…

    Trinity Health (Syracuse, NY)
    …specific job functions: . Participation in Quality Auditing of St. Josephs Health providers and department RA coders (2 currently requisitioned) with educational ... determination and communication to the Supervisor, RA Coding & Audit . Key contributor duties related to CCD/HCC and...Word, Excel, Outlook and Teams. . Adept in Electronic Health Records and Professional Billing systems . High School… more
    Trinity Health (05/29/25)
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