• Revenue Cycle Coordinator IV

    University of Rochester (Rochester, NY)
    …trends of incorrectly paid claims from specific payers - - Work with supervisor/ manager on communication to payer representatives regarding payment trends and ... specialized services. Revenue Collection activities focus on an assigned payer billed at the primary level. Schedule 7:30 AM-4...tasks, following standard procedures, and as directed by the Manager , Billing or Manager . Independent judgement is… more
    University of Rochester (03/17/25)
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  • Director, System Payer Contracting

    Albany Medical Center (Albany, NY)
    … terms. The Director is skilled at drafting, analyzing, and negotiating complex payer contracts . The Director develops contract proposals and leads ... and builds systems and standardized processes to facilitate multi-stakeholder collaboration on payer contracts to achieve best negotiation outcomes. + Develops… more
    Albany Medical Center (04/16/25)
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  • 340B Accountant; HSO Pharmacy; Mount Sinai Health…

    Mount Sinai Health System (New York, NY)
    …collection procedures to obtain third party payments and ensure compliance with payer contracts . Ensure accuracy of secondary billing processes and related ... collection procedures to obtain third party payments and ensures compliance with MSHS payer contracts . * Ensures accuracy of secondary billing processes and… more
    Mount Sinai Health System (04/08/25)
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  • Manager , Provider Contracts

    Molina Healthcare (Albany, NY)
    …models in concert with Director. * Oversees the maintenance of all Provider and payer Contract Templates. Works with legal and Corporate Network Management on an ... credentialing. **Knowledge/Skills/Abilities** * In conjunction with the Director, Provider Contracts , develops health plan-specific provider contracting strategies, identifying specialties… more
    Molina Healthcare (04/20/25)
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  • Revenue Cycle Coordinator IV - Remote/Hybrid…

    University of Rochester (Rochester, NY)
    …and with latitude for independent judgment: 35% For hospital billing: - Review Coverage Manager II work queues. Review payer coverage changes made at the patient ... models. Ensures that charges are processed per models as well as payer policies and regulations regarding placement of modifiers. Supervision and Direction… more
    University of Rochester (03/17/25)
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  • Registered Nurse Case Manager -Suffolk…

    Northwell Health (Huntington, NY)
    **Req Number** 152919 Registered Nurse Case Manager - FlexStaff Serves as liaison between the patient and facility/physician. Ensures a continuum of quality patient ... clinical course + Ensures compliance with current state, federal, and third party payer regulations + Documents the case management process in the medical record;… more
    Northwell Health (03/11/25)
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  • Medicaid Contract Director

    Highmark Health (Albany, NY)
    …:** **JOB SUMMARY** This job is responsible for the oversight of the Medicaid contract and is available for prompt response to direct inquiries from the state ... care organization (MCO) contractual performance as specified in the contract and to help achieve the Organization's goals and...or requested. ​ **EXPERIENCE** **Required** + 5 years healthcare payer (insurance) or related experience. + 5 years of… more
    Highmark Health (04/29/25)
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  • Insurance Verification Representative - Manhattan…

    Surgery Care Affiliates (New York, NY)
    …Orientation: + Calculate co-pay, and estimated co-insurance due from patients per the individual payer contract per the individual payer contract and ... process of collecting over the counter payments/deductibles/copay/co-insurance. Knowledge of payer contracts including Medicare, Medicaid and other government… more
    Surgery Care Affiliates (04/23/25)
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  • Senior CBO Appeals Analyst

    Mount Sinai Health System (New York, NY)
    …Develops and maintains standard contract compliance analyses of MSHP IPA negotiated contracts utilizing contract manager and other data sources. 4. ... experience in a hospital/healthcare environment is required. Advanced knowledge of Epic, Contract Manager , and Microsoft Excel Working knowledge of other… more
    Mount Sinai Health System (02/15/25)
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  • Senior Network Provider Manager

    CVS Health (Albany, NY)
    …development of holistic solutions or strategic plans negotiates and executes contracts with the most complex, market /region/national, largest group/system or ... value/volume of spend providers with significant financial implications. + Manages contract performance, and drives the development and implementation of value based… more
    CVS Health (04/26/25)
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