• Clm Resltion Rep III, Hosp/Prv

    University of Rochester (Rochester, NY)
    …- reason code or denial codes in EPIC. + View Payer Website link (EPIC Insurance Coverage tab), review payer website, or contact payer representative as to why ... incorrectly paid claim completing resolution and adjudication. + Adjust account or process insurance refund credits. + Review and advise supervisor or manager of… more
    University of Rochester (08/07/25)
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  • Utilization Manager Reviewer, RN (Multiple…

    Excellus BlueCross BlueShield (Rochester, NY)
    …services requested for the diagnosis and treatment of members' medical health conditions, applying established clinical review criteria, guidelines and ... in conjunction with Provider Relations, explaining processes for accessing Health Plan to perform medical review...the total rewards package may include participation in group health and/or dental insurance , retirement plan, wellness… more
    Excellus BlueCross BlueShield (08/23/25)
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  • Section Supervisor

    City of New York (New York, NY)
    …CIVIL SERVICE TITLE. The Medical Assistance Program (MAP) administers public health insurance programs, including Medicaid, for the City of New York. ... reimbursement claims of consumers receiving public health insurance which include reimbursable homecare, medical service...difficult or highly unusual cases related to the Third-Party Health Insurance coverage, cost effective review more
    City of New York (06/15/25)
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  • Nurse Supervisor Hemodialysis

    Bassett Healthcare (Little Falls, NY)
    …offerings include: Paid time off, including company holidays, vacation, and sick time Medical , dental and vision insurance Life insurance and disability ... you looking to make a difference by improving the health of our patients? Here you will find an...staff requests as monitored by staff feedback and supervisor review Consistently supports staff education needs by scheduling in-service… more
    Bassett Healthcare (08/28/25)
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  • Registered Nurse RN Full Time

    Gateway Hudson Valley (Kingston, NY)
    …strive to achieve a hopeful, satisfying, active, and contributing life. We offer Medical , Dental, Life Insurance , 403(b) Retirement, Holidays, and generous PTO. ... are validated by the responsible individual. + Monitor and review IRA resident and selected trainee medical ...staff occurs. + Serve as a member of the Health and Safety, Intake/Termination and Incident Review more
    Gateway Hudson Valley (07/19/25)
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  • Patient Access Representative - Emergency Room…

    Stony Brook University (Stony Brook, NY)
    …and/or hospital patient access, intake, registration experience. + Familiarity with medical insurance benefits, demonstrated experience with EMR computerized ... Associate's Degree with one year of working experience in a customer service, public health , healthcare, or related industry such as insurance . _In lieu of… more
    Stony Brook University (08/16/25)
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  • Revenue Cycle Coordinator IV

    University of Rochester (Rochester, NY)
    …follow up to obtain correct full reimbursement - Billing primary and secondary claims to insurance - Review paper claims prior to billing. Review include ... Activities performed will focus on resolving balances on aged insurance accounts which have not been collected through routine...resolution and adjudication, including refund of credits - - Review and advise supervisor or manager on trends of… more
    University of Rochester (08/07/25)
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  • Senior Private Equity Broker, Middle Market…

    AON (New York, NY)
    …shorter and more complex than a traditional renewal timelines. + Analyze and review insurance programs for clients to determine optimum program including ... plan; consideration for long-term incentive awards at Aon's discretion; medical , dental and vision insurance , various types...complex than a traditional renewal timelines. + Analyze and review insurance programs for clients to determine… more
    AON (07/03/25)
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  • Pharmacy Manager

    Walgreens (Bronx, NY)
    …accurately to prevent payment rejections. Resolves patient issues by working with insurance companies and medical providers and conducting or participating in ... improvement. Business Planning + Develops and maintains good relationships with local medical community including physicians, nurses, and other health care… more
    Walgreens (08/31/25)
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  • Risk Adjustment Coding Specialist (Remote in New…

    CDPHP (Latham, NY)
    …of medical record review and diagnosis coding within the health insurance industry. + Demonstrated ability to research, analyze and interpret CMS ... not-for-profit health plan that offers high-quality affordable health insurance to members throughout New York....adjustment eligible members. This position will have responsibility for review of medical records to identify accurate… more
    CDPHP (08/27/25)
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