• Referral & Authorization Specialist - Cancer…

    Glens Falls Hospital (Glens Falls, NY)
    …& Authorization Specialist! This position can further develop your skills in compliance , medical billing, customer service, and Health Information Management ... service to be rendered as applicable (as well as medical records) . Interview patients to apprise them of...prior authorization . Gather additional clinical and / or coding information as necessary in order to obtain prior… more
    Glens Falls Hospital (10/01/25)
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  • Senior Medical Biller (CPC or CPA…

    FlexStaff (New York, NY)
    … medical billing and claims processing, and insurance follow-up. * Certification in medical billing and coding preferred (eg, CPC, CPA, or equivalent). * ... Number** 166842 We are looking for a seasoned Senior Medical Biller with extensive experience and strong technical knowledge...In-depth knowledge of CPT, ICD-10, and HCPCS coding systems. Responsibilities: * Timely and accurately submit claims… more
    FlexStaff (09/05/25)
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  • Pharmacy Revenue Integrity

    Albany Medical Center (Albany, NY)
    …revenue integrity, patient financial services, prior authorization teams, denial specialists, compliance , and other key stakeholders. This individual will serve as a ... subject matter expert in the setting of medication-related compliance billing and charging processes. They are responsible for ensuring the accuracy and … more
    Albany Medical Center (08/14/25)
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  • Medical Office Assistant I

    Bassett Healthcare (Middleburgh, NY)
    …optimum health and enjoy the best quality of life possible. What you'll do The Medical Office Assistant I serves as the first point of contact for patients within ... you?") as observed by Supervisor and as noted in compliance reports + Ends calls by asking patient if...needs are met) or prescription requests using the electronic medical record messaging system as observed by Supervisor and… more
    Bassett Healthcare (09/19/25)
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  • Medical Director - Southeast Region

    Humana (Albany, NY)
    **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... an in-depth evaluation of variable factors. **Job Profile** The Medical Director actively uses their medical background,...authorized. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which… more
    Humana (09/10/25)
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  • ProFee Clinical Documentation Specialist

    Catholic Health Services (Melville, NY)
    …missing clinical documentation to support diagnoses These reviews are in contrast to coding / compliance reviews, which evaluates what is written in the encounter ... by the specialty and other chronic conditions that are addressed as part of medical decision making and the treatment plan + Assesses E/M level and identifies… more
    Catholic Health Services (09/24/25)
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  • Investigator, Special Investigative Unit - FLORIDA

    Molina Healthcare (Syracuse, NY)
    …to health care fraud, waste, and abuse. Duties include performing accurate and reliable medical review audits that may also include coding and billing reviews. ... responsible for recognizing and adhering to national and local coding and billing guidelines in order to maintain ...position may also work with other internal departments, including Compliance , Corporate Legal Counsel, and Medical Officers… more
    Molina Healthcare (09/22/25)
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  • Medical Records Technician (Health…

    Justice, Bureau of Prisons/Federal Prison System (Kings County, NY)
    …preparing individuals for successful reentry into our communities. Responsibilities Analyzes medical records for completeness, consistency and compliance with ... medical records, and documentation requests and have the ability to examine medical records for completeness, consistency and compliance with Joint Commission… more
    Justice, Bureau of Prisons/Federal Prison System (09/30/25)
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  • Medical Director-Payment Integrity

    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 ... at the Inpatient level. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which may include national clinical… more
    Humana (09/26/25)
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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 ... service should be authorized. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which may include national… more
    Humana (09/17/25)
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