• Medical Director - Southeast Region

    Humana (Albany, NY)
    …participation in care management. The clinical scenarios predominantly arise from inpatient or post-acute care environments. Has discussions with external physicians ... require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient… more
    Humana (09/10/25)
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  • Director Revenue Cycle Applications IT

    Stony Brook University (St. James, NY)
    …revenue cycle operations. This includes oversight of multi-hospital inpatient and outpatient services, physician practice registration, scheduling, health ... Capture, Visitor Management, online payment solutions, Document Imaging, Diagnostic Coding , Deficiency Management, and Enterprise Master Patient Index across… more
    Stony Brook University (09/23/25)
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  • Analyst, Configuration Oversight (Claims Auditor)

    Molina Healthcare (Buffalo, NY)
    …and services billed under Institutional and non-institutional claims. * Validates coding , updating and maintaining benefit plans, provider contracts, fee schedules ... principles and state specific policies and regulations to identify incorrect coding , abuse and fraudulent billing practices, waste, overpayments, and processing… more
    Molina Healthcare (09/17/25)
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  • Utilization Review Nurse

    CDPHP (Latham, NY)
    …Directors on denials. In addition, the UR nurse is responsible for completing inpatient level of care reviews, post-acute care initial and concurrent reviews for ... acute and subacute rehabilitation, transportation, DME requests and inpatient readmissions. In collaboration with management, the UR nurse identifies potentially… more
    CDPHP (09/23/25)
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  • Medical Director - Claims Management

    Humana (Albany, NY)
    …may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, dispute, grievance, and appeals processes, and ... post residency or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled… more
    Humana (09/17/25)
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  • Pulmonary/Critical Care Physician - HealthAlliance…

    WMCHealth (Kingston, NY)
    …an emphasis on pulmonary and sleep medicine, while also providing limited inpatient consultative and ICU coverage opportunities. This is an excellent opportunity to ... providers and respiratory therapists to optimize patient care. + Inpatient Consultative Services + Provide pulmonary consultations for hospitalized patients… more
    WMCHealth (09/12/25)
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  • Coder IV

    Kaleida Health (Olean, NY)
    …Information Management (HIM) or supervisor of HIM, accurately code inpatient and outpatient (for example, diagnostic, therapeutic, emergency department services, ... and procedures as documented in the ICD-9-CM Official Guidelines for Coding and Reporting. Resolve error reports associated with billing processes, identify… more
    Kaleida Health (09/03/25)
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  • Outpatient Administrative Specialist - Emergency…

    SUNY Upstate Medical University (Syracuse, NY)
    …shift to follow up to admit patients with admit to Observation or Inpatient order. Complete appropriate forms before patient leaves the ED when possible. Updating ... functions and ADT transactions in Epic: change of service and/or attending, inpatient bed swaps and transfers. Death certificates: review autopsy form to determine… more
    SUNY Upstate Medical University (07/09/25)
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  • Lead Patient Access Specialist MHB

    Catholic Health (Buffalo, NY)
    …Lead oversees the daily/evening operations in the delivery of care to inpatient and outpatient populations in the Admissions/Patient Registration/ER Areas. As a ... terminology background and strong insurance background required. Knowledge of ICD-10 coding , physician orders, medical necessity ABN regulations + Must demonstrate… more
    Catholic Health (09/28/25)
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  • Patient Access Specialist

    Saratoga Hospital (Malta, NY)
    …Assists management with quality assurance as needed. Admitting areas- complete inpatient admission process. * Verify Insurance: Obtains insurance information and ... and verification tools and online resources. Check Medical Necessity. Diagnosis Coding and abstracting when needed by department. Able to complete authorization… more
    Saratoga Hospital (09/27/25)
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