• Senior Claim Benefit Specialist - Stop Loss…

    CVS Health (Albany, NY)
    …by the stop loss carrier. **Required Qualifications** *Minimum of 1 year of experience in healthcare claims processing *Minimum of 2 years of experience with ... This challenging role provides exposure to virtually all aspects of healthcare claims administration, from reinsurance/stop loss, data analytics, provider… more
    CVS Health (08/23/25)
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  • Specialist, Configuration Oversight…

    Molina Healthcare (Albany, NY)
    …communicate written and verbal + Knowledge of verifying documentation related to updates/changes within claims processing system . + Experience using claims ... equivalent combination of education and experience **PREFERRED EXPERIENCE:** 3+ years Healthcare Claims Adjudication **PHYSICAL DEMANDS:** Working environment is… more
    Molina Healthcare (08/16/25)
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  • Claims Processing Tech II…

    Trinity Health (Troy, NY)
    **Employment Type:** Full time **Shift:** Day Shift **Description:** ** Claims Processing Tech II -** **Community Hospice** **- FT Days** **Narrative:** The ... * Obtaining service authorizations * Reviewing and submitting electronic claims * Reviewing cash postings * Following up on...problem-solving * A desire to thrive in a fast-paced healthcare environment Full orientation is provided. Apply today for… more
    Trinity Health (08/13/25)
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  • Director, Appeals & Grievances (Medicare…

    Molina Healthcare (Rochester, NY)
    …Experience. **Required Experience** * 7 years' experience in healthcare claims review and/or Provider appeals and grievance processing /resolution, including ... Contracted Provider disputes and appeals to ensure adherence with Molina claims processing standards and provider contractual agreements. Includes responsibility… more
    Molina Healthcare (07/18/25)
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  • Claims Processor (with Facets)…

    Cognizant (Albany, NY)
    …+ 1 year of Facets experience. + Experience in the analysis and processing of claims for payments, utilization review/quality assurance procedures. + Must ... ET **Experience:** A minimum of 2 years of claim processing is required. **Travel:** None required **About the role:**...is required. **Travel:** None required **About the role:** As Claims Processor (with Facets), you will be responsible for… more
    Cognizant (08/22/25)
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  • Senior Contracting Compliance Analyst - Hospital…

    Mount Sinai Health System (New York, NY)
    … processes, and related regulations. * Familiarity with contract terms, NYS regulations, claims processing , and healthcare reimbursement models. * Experience ... Minimum of 7 years of experience in contract compliance, healthcare compliance, or revenue cycle management, with a strong...to ensure proper interpretation and application of terms during claims processing . * Ensure that all contract… more
    Mount Sinai Health System (08/12/25)
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  • Medical Claims Adjudication - remote

    Cognizant (Albany, NY)
    …duties as assigned by management. **Qualifications:** + A minimum of 2 years' claims processing experience is required. + Knowledge of physician practice and ... for payments, utilization review/quality assurance procedures. + Excellent problem-solving skill in healthcare claims adjudication. + Ability to work at a… more
    Cognizant (08/01/25)
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  • Claims Specialist Temp- FlexStaff

    Northwell Health (New York, NY)
    …conditions + Validates DRG grouping and (re)pricing outcomes presented by the claims processing vendor. Attends JOC meetings with providers as appropriate ... creating and testing compensation grids used for reimbursement and claims processing + Ensures that refund checks...Eight or more years of insurance experience within a healthcare or managed care setting (preferred) + Claims more
    Northwell Health (08/23/25)
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  • Leader, Claims Support

    MVP Health Care (Schenectady, NY)
    …**Your key responsibilities:** + Mentor, support, and build a high-performing team within Claims Operations. + Supervise claims processing activities related ... improvement. To achieve this, we're looking for a Leader, Claims Support to join #TeamMVP. If you have a...that may arise, reflecting our collective goal of enhancing healthcare delivery and being the difference for the customer.… more
    MVP Health Care (08/23/25)
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  • Claims Specialist Hybrid- FlexStaff (Temp)

    FlexStaff (Bronx, NY)
    …Subrogation conditions + Validates DRG grouping and (re)pricing outcomes presented by the claims processing vendor + Attends JOC meetings with providers as ... creating and testing compensation grids used for reimbursement and claims processing + Ensures that refund checks...Eight or more years of insurance experience within a healthcare or managed care setting (preferred) + Prior third… more
    FlexStaff (08/23/25)
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