• Registered Nurse - Remote

    Cognizant (Albany, NY)
    …the Health Plan/Payer. The comprehensive process includes analyzing, reviewing, and processing medical necessity denials for resolution. You will be a valued member ... accounts. . Maintain working knowledge of applicable health insurers' internal claims , appeals, and retro-authorization as well as timely filing deadlines and… more
    Cognizant (10/07/25)
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  • Coding Specialist, Ambulatory Surgery Center

    Excelsior Orthopaedics Group (Amherst, NY)
    …coding regulations. + Manage billing functions for surgical procedures, including claim creation, submission, and follow -up for payment resolution. + ... Job Summary We are seeking a detail-oriented and experienced Medical Coder to join our Ambulatory Surgery Center (ASC)...required. + Minimum of 1 year of experience in medical coding and/or billing, preferably in an orthopedic or… more
    Excelsior Orthopaedics Group (10/05/25)
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  • Credentialing Specialist HCS

    Catholic Health (Buffalo, NY)
    …analyze data and prepare meaningful reports + Ability to identify, react, and follow through in an appropriate manner in credentialing matters + Must remain ... confidential on all Medical Staff matters + Create individual and group NPIs...+ Submit completed payer applications to insurance payers + Follow up with insurance payers to ensure credentialing is… more
    Catholic Health (10/05/25)
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  • Financial Assistant - Billing Specialist

    Lakeview Health Services (Geneva, NY)
    …Benefits + Personal Time Off (PTO) Accrual + 401(k) with Agency match + Voluntary Medical / Dental/ Vision + Employer Funded Life Insurance + 9 Paid Holidays and 1 ... is responsible for a variety of office/clerical tasks relating to claims processing; contacting responsible parties to resolve past-due accounts; investigating… more
    Lakeview Health Services (10/08/25)
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  • Account Relations Representative III

    Canon USA & Affiliates (Melville, NY)
    …Coordination, System Support, Contract Coordination, managing sales funds, validating claims , issuing credits and Business Process Improvement and Problem Solving ... Vendor portal agreements - Sales Fund Management - Validate claims - Agreement review - Issue credits - Reporting...- Must be analytical and extremely detailed with excellent follow up and problem solving skills - Keen sense… more
    Canon USA & Affiliates (10/07/25)
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  • SCA Customer Care Representative I

    Elevance Health (East Syracuse, NY)
    …via telephone and written correspondence regarding benefits, contracts, eligibility and claims . + Analyzes issues and provides information and/or solutions. + ... customers with requested information. + Under immediate supervision, receives and places follow -up telephone calls / e-mails to answer questions that are routine in… more
    Elevance Health (10/04/25)
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  • Customer Care Representative I

    Elevance Health (New York, NY)
    …via telephone regarding insurance benefits, provider contracts, eligibility and claims . + Analyzes problems and provides information/solutions. + Operates a ... customers with requested information. + Under immediate supervision, receives and places follow -up telephone calls / e-mails to answer customer questions that are… more
    Elevance Health (09/09/25)
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  • Clinical Reviewer

    Independent Health (Buffalo, NY)
    …Clinical Reviewer will be responsible for the collection and review of medical records specific to quality complaints/grievances and appeals as indicated in support ... and lead coordination of clinical review with appropriate internal stakeholders and Medical Director. This position will prepare written responses to appeals and… more
    Independent Health (10/07/25)
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  • Investigative Officer 2 (Sif) - Policyholder…

    New York State Civil Service (Melville, NY)
    …in training opportunities to enhance investigative skills for the detection of claims fraud, policy fraud and medical provider fraud. Minimum Qualifications ... private investigator reports, police reports, payroll records, business records, medical records, financial records, and policyholder records to determine the… more
    New York State Civil Service (10/08/25)
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  • Pharmacy Access Rep III - Home Infusion

    University of Rochester (Rochester, NY)
    …to acquire necessary information and assembly of documentation necessary to submit claims to the patient's insurance for approval including prior authorization and ... clinical employees at various levels including pharmacists, pharmacy technicians, medical /clinical staff, and central prior authorization staff. External interactions… more
    University of Rochester (08/07/25)
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