• Specialist, Appeals & Grievances

    Molina Healthcare (Syracuse, NY)
    …and requirements established by the Centers for Medicare and Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for the comprehensive research and resolution ... claims processing background, including coordination of benefits, subrogation, and eligibility criteria. + Familiarity with Medicare claims and appeals processing,… more
    Molina Healthcare (10/03/25)
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  • ACA/Medicare Risk Adjustment Analyst Sr.

    Baylor Scott & White Health (Albany, NY)
    …independently and with cross functional groups.Knowledge of ACA, Medicare, Medicaid , MCO, TPA business requirements preferred.Experience with healthcare encounters, ... preferred. **BENEFITS** Our competitive benefits package includes the following- Immediate eligibility for health and welfare benefits- 401(k) savings plan with… more
    Baylor Scott & White Health (10/03/25)
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  • Authorization Coordinator

    Catholic Health Services (Melville, NY)
    …National and Local Coverage Decisions. + Maintain knowledge of Medicare, Medicaid and third-party payer regulations and hospital charging and collection policies. ... medical terminology. + Work requires the ability to access online insurance eligibility and pre- certification systems. + Must have expertise in insurance, managed… more
    Catholic Health Services (10/03/25)
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  • Manager Information Technology Services 2

    New York State Civil Service (Schenectady, NY)
    …and Billing System (TABS). TABS generates approximately $2,000,000,000 in Medicaid claims annually and reconciles those claims, while generating approximately ... qualify. Ensure that you include the vacancy ID in the subject of your email for prompt routing. Your Social Security number may be required to confirm eligibility . more
    New York State Civil Service (10/02/25)
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  • Nurse Educator

    CVS Health (NY)
    …Dual Eligible Special Needs Plan (DSNP) members, who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. ... retiree medical access and many other benefits depending on eligibility . For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the… more
    CVS Health (10/01/25)
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  • Tenant Support Specialist

    Catholic Charities Family Community Services (Rochester, NY)
    …Tenant Support Specialist will provide pre-tenancy and tenancy sustaining services to qualified Medicaid Managed Care Members for up to 6 months. The Tenant Support ... prioritize tasks. + Knowledge of local housing options, rental laws and program eligibility + Ability to build rapport with clients from diverse backgrounds +… more
    Catholic Charities Family Community Services (09/30/25)
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  • Lead Patient Access Specialist MHB

    Catholic Health (Buffalo, NY)
    …demonstrated computer proficiency + Familiarity with insurance plans, such as Medicare, Medicaid , private and commercial is required + Familiarity with insurance ... eligibility tools such as HDX, HealtheNet, Omni Pro, ePaces, and any other online tools + Able to multitask REQNUMBER: 39810 more
    Catholic Health (09/28/25)
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  • Disability Services Program (DSP) Clerk

    City of New York (New York, NY)
    …Services Program (DSP) assists clients in obtaining disability through either the Medicaid under Aid to the Disabled (MA-AD) program or the Social Security ... on the status of referrals submitted. Verify participants status, demographics, and eligibility for DSP services via accessing other systems including, but not… more
    City of New York (09/27/25)
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  • Kinney Homecare Regional Sales Manager

    KPH Healthcare Services, Inc. (Camillus, NY)
    …and building customer relationships + Knowledge of payer sources (Medicare, Medicaid , private insurance) and DME billing practices **Special Conditions of ... exclusion and sanction/disciplinary monitoring + Any and all additional eligibility requirements based on the specific position **Compensation** $61,000-$65,000… more
    KPH Healthcare Services, Inc. (09/26/25)
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  • Patient Access Specialist

    Planned Parenthood of Greater New York (Schenectady, NY)
    …systems in high-volume customer service setting * Experience with insurance eligibility online platforms (ePACES, Availity, etc.) Subject Matter Knowledge * Strong ... knowledge of Medicare and Medicaid practices in the outpatient setting. * Understanding of insurance practices. Work Habits/Attributes * Keen attention to detail *… more
    Planned Parenthood of Greater New York (09/25/25)
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