• Accounts Receivable Specialist

    Glens Falls Hospital (Glens Falls, NY)
    …Fulfill Your Potential* *Responsibilities* * Corrects pre-billing edits and ensures outbound claim compliance Follow -up on A/R in accordance with pre-established ... *The Impact You Can Make* Attention all dedicated medical billing professionals!! The Patient Financial Services (PFS)...play a key role in the timely accounts receivable follow up and collections. Some highlights about this opportunity… more
    Glens Falls Hospital (10/01/25)
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  • ACA/Medicare Risk Adjustment Analyst Sr.

    Baylor Scott & White Health (Albany, NY)
    …2 Years of Experience in Healthcare Analytics + 2 years working with ACA and Medical Claims , MMR, MOR, MAO-002, MAO-004 and RAPs/EDS data + Experience with ... and outbound encounter process. + Monitors and oversees the end-to-end claims encounter management workflow. + Identifies and interprets encounter data, submission… more
    Baylor Scott & White Health (10/03/25)
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  • RN Utilization Review - System Care Management…

    Guthrie (Binghamton, NY)
    …System process improvement. + Denials Adjudication 1. Facilitate review of rejected medical claims using clinical evidenced based tools and peer-reviewed ... plans and related UM requirements preferred. Experience with CPT/ICD coding, medical record or chart auditing, and experience in utilization management processes… more
    Guthrie (10/04/25)
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  • Coding Auditor Educator-Inpatient

    Highmark Health (Albany, NY)
    …related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, ... Contractor, the RAC, MIC, ZPIC, etc. Determine appeal action, prepare appeal letter follow up and identify education issues. (20%) + Develops audit detail summary… more
    Highmark Health (09/20/25)
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  • Self-Pay Collection Rep II

    University of Rochester (Rochester, NY)
    …the department and Strong Memorial Hospital (SMH), Highland Hospital and Medical Faculty Group (MFG) in a professional manner, protecting confidentiality of ... related to the following: + Bankruptcy filings and resolution + Estate Claim verification + Presumptive financial assistance + Other recommendations to resolve… more
    University of Rochester (08/07/25)
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  • Medical Records Coder III, Complex

    University of Rochester (Rochester, NY)
    …expertise of the individual, and internal equity considerations._ **Responsibilities:** The Medical Coder III functions as an advanced coder in the abstraction ... and in-depth analysis of a variety of medical documentation and assigns appropriate procedural terminology and ...- Reviews and resolves coding denials. Resolves problems with claims having errors related to improper coding and provides… more
    University of Rochester (08/07/25)
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  • Medical Records III, Complex

    University of Rochester (Rochester, NY)
    …advanced coder in the abstraction and in-depth analysis of a variety of medical documentation and assigns appropriate procedural terminology and medical codes in ... and manipulates database. Responds to or clarifies internal requests for medical information. **ESSENTIAL FUNCTIONS** + Uses thorough knowledge of coding systems… more
    University of Rochester (08/07/25)
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  • Investigator, Special Investigative Unit - FLORIDA

    Molina Healthcare (Syracuse, NY)
    …the Medicaid and Medicare programs as well as Marketplace. + Understanding of claim billing codes, medical terminology, anatomy, and health care delivery ... health care fraud, waste, and abuse. Duties include performing accurate and reliable medical review audits that may also include coding and billing reviews. The SIU… more
    Molina Healthcare (09/22/25)
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  • Manager, Medical Director - Transformation…

    Elevance Health (New Hyde Park, NY)
    **Manager, Medical Director - Transformation Initiatives** Location: This role requires associates to be in-office 3 days per week, fostering collaboration and ... granted as required by law. Alternate locations may be considered. The **Manager, Medical Director** will serve as a clinical and strategic advisor to enterprise… more
    Elevance Health (10/04/25)
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  • Senior Manager Medical Assessment Center

    MTA (Mineola, NY)
    Senior Manager Medical Assessment Center Job ID: 12521 Business Unit: MTA Headquarters Location: Mineola, NY, United States Regular/Temporary: Regular Department: ... Services Date Posted: Jul 29, 2025 Description JOB TITLE: Senior Manager, Medical Assessment Center DEPT/DIV: Occupational Health Services WORK LOCATION: 300 Old… more
    MTA (07/30/25)
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