• Workers Compensation Claims Associate | NY…

    Sedgwick (Syracuse, NY)
    …is correct. + May process routine payments and prescriptions and status reports for lifetime medical claims and/or defined period medical claims . + ... Fortune Best Workplaces in Financial Services & Insurance Workers Compensation Claims Associate | NY Medical Only Claims | Syracuse, NY Are you looking… more
    Sedgwick (09/17/25)
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  • Legal Nurse|Review Medical Malpractice…

    New York State Civil Service (New York, NY)
    NY HELP No Agency Attorney General, Office of the Title Legal Nurse|Review Medical Malpractice Claims for NYS (6402) Occupational Category Legal Salary Grade NS ... application online at ag.ny.gov/job-postings/otherOpportunity for Registered Nurses or Licensed PhysiciansThe Medical Malpractice Unit of the Claims Bureau in… more
    New York State Civil Service (10/15/25)
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  • Team Lead for Medical Claims

    FlexStaff (Chappaqua, NY)
    …Number** 168166 Claims Management Specialist Are you a seasoned medical insurance professional with a passion for leadership and operational excellence? ... Qualifications: - Minimum of 3-5 years of experience in medical insurance billing and claims management, with a focus on Medicare, Medicaid, and Out-of-Network… more
    FlexStaff (09/24/25)
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  • Medical Director - Claims Management

    Humana (Albany, NY)
    …a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare, Medicare Advantage, and Medicaid requirements… more
    Humana (10/16/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Rochester, NY)
    …to providers. **Job Duties** + Performs clinical/ medical reviews of retrospective medical claim reviews, medical claims and previously denied cases, ... documentation for denial and modification of payment decisions + Independently re-evaluates medical claims and associated records by applying advanced clinical… more
    Molina Healthcare (09/06/25)
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  • Specialist, Config Oversight (healthcare…

    Molina Healthcare (Rochester, NY)
    …combination of education and experience **PREFERRED EXPERIENCE:** 3+ years healthcare Medical claims auditing **PHYSICAL DEMANDS:** Working environment is ... clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains… more
    Molina Healthcare (09/24/25)
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  • Medical Billing Specialist

    KPH Healthcare Services, Inc. (Syracuse, NY)
    …Summary:** Responsible for developing, improving and continuing the process billing of medical claims for specialty pharmacy facilities. Needs to communicate ... assigned tasks. Establish, manage, and communicate the process of billing medical claims for specialty facilities. **Responsibilities** **Job Duties:** +… more
    KPH Healthcare Services, Inc. (10/08/25)
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  • Medical Billing Specialist

    Robert Half Accountemps (Rochester, NY)
    …and coding within a healthcare setting. * Strong knowledge of ICD-10 codes and medical claims processes. * Familiarity with medical collections and insurance ... Description We are looking for a skilled Medical Billing Specialist to join our team in...operations. Responsibilities: * Prepare, review, and submit accurate insurance claims in alignment with established deadlines. * Process payments… more
    Robert Half Accountemps (10/05/25)
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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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  • Billing Specialist - Pharmacy Technician

    Independent Health (Buffalo, NY)
    …is primarily responsible for completing the billing of both pharmacy and medical claims and adjudicating rejections. **Signing Bonus:** This position will ... and payor billing/shipping requirements. + Process and set up deliveries to medical offices. + Medical claims billing for both supplies and medications. +… more
    Independent Health (09/10/25)
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