• Director, Clinical Data Acquisition

    Molina Healthcare (Albany, NY)
    …projects, and other state specific audit projects and deliverables related to accurate billing and coding . This role also works with the Health Plan ... supplemental data source (SDS) acquisition from providers as well as Electronic Medical Record (EMR) access. This position oversees management of training for all… more
    Molina Healthcare (10/22/25)
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  • Manager, Special Investigation

    CVS Health (Albany, NY)
    …States: **Texas, Ohio, New York, and Oklahoma** + Experience with Interpreting Contracts + Billing and Coding certifications such as CPC (AAPC) + Knowledge of ... to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and… more
    CVS Health (10/19/25)
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  • Key Account Manager - Cardiovascular - Long Island

    Amgen (New York, NY)
    …strategic account management in state or federal sector + Knowledge of payor systems, billing , coding and reimbursement processes + Knowledge of CMS policies and ... closely with Organized Customer Team Regional Account Executives and Regional Medical Liaisons in shared accounts + Coordinates with Reimbursement Access Value… more
    Amgen (10/12/25)
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  • Outpatient LPN Coordinator - Orthopedics

    Arnot Health (Elmira, NY)
    …procedures (example - EKG, PFS, aseptic technique) d. Maintains basic knowledge of coding and billing processes e. Schedules follow up visits, consultations, ... descriptions, evaluates and disciplines staff in the division in accordance with Medical Center policies. 4. Mediates and resolves problems for physicians, patients… more
    Arnot Health (09/04/25)
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  • Forensic Auditor: Investigate Complex Medicaid…

    New York State Civil Service (New York, NY)
    …sampling and/or advanced statistical training.* Knowledge of the healthcare industry and medical coding concepts (CPT, ICD-9 / 10, DRGs) and/or experience ... as pharmaceutical companies, doctors, hospitals, and nursing homes, who engage in Medicaid billing schemes that cause harm to Medicaid recipients and the loss of… more
    New York State Civil Service (11/19/25)
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  • Dental Review Analyst (Registered Dental…

    Excellus BlueCross BlueShield (Buffalo, NY)
    …codes, dental interpretation, etc (Sr. level). Is knowledgeable of mandates for medical /dental coverage specific to NY state for accidental injury coverage and ... + Participates in activities reflecting Dental Review activity such as procedure coding development and fraud and abuse. Monitors utilization, cost and quality of… more
    Excellus BlueCross BlueShield (11/17/25)
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  • Senior Reimbursement Specialist

    Centene Corporation (New York, NY)
    …City, NY** + Research and analyze provider reimbursement methodologies and regulatory medical coding requirements to ensure alignment with state requirements. + ... Medicare and Medicaid reimbursement methodology. Managed care experience and provider billing experience preferred. Pay Range: $55,100.00 - $99,000.00 per year… more
    Centene Corporation (11/15/25)
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  • Patient Access Liaison I

    Nuvance Health (Poughkeepsie, NY)
    …eligibility transactions via the internet, contacting the payor to obtain billing information and authorization and scripts for service when appropriate. 7. ... in the appropriate system when necessary. Requires an understanding of coding , procedural protocols, and the charge description master. 9. Employee responsible… more
    Nuvance Health (11/14/25)
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  • Pharmacy Manager - Outpatient Infusion - Full Time…

    Mohawk Valley Health System (Utica, NY)
    …training, competency assessment, and performance feedback. + Collaborate with nursing, medical oncology, and hospital administration to align infusion services with ... for formulary management, contract optimization, and cost containment. + Coordinate with billing and revenue integrity teams to ensure accurate charge capture and… more
    Mohawk Valley Health System (11/11/25)
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  • Dental Patient Service Representative

    OLV Human Services (Lackawanna, NY)
    …guardian and notifies dental team of the approval or denial of the predetermination Billing Review: * Post payments and denials * Utilizes denial reports to assess ... documentation against posted charges; engages provider to mitigate documentation and coding errors * Reconciles daily schedules and charges * Creates electronic… more
    OLV Human Services (11/08/25)
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