• Utilization Manager Reviewer, RN (Multiple…

    Excellus BlueCross BlueShield (Rochester, NY)
    …coordinating, integrating, and monitoring the utilization of physical health (PH) medical and healthcare services for members, ensuring compliance with internal and ... standards set by regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review. Refer to and work closely with Case Management… more
    Excellus BlueCross BlueShield (08/23/25)
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  • Revenue Cycle Assistant- Patient Financial…

    Mount Sinai Health System (New York, NY)
    …GED required. Associate degree preferred. + 1-2 years of experience in medical practice/outpatient coding /payment/charge posting preferred. + Excel, Typing and ... data and ensure proper reimbursement for services provided and in compliance with coding , payment rules and regulations. **Qualifications** + High School Diploma or… more
    Mount Sinai Health System (08/19/25)
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  • Full-Time - Practice Scribe - Orthopedics

    Northwell Health (Bohemia, NY)
    …or written chart. Ensures medical record is accurate, complete and meets medical coding requirements. Assists in coordinating organization of care to meet ... Medical Assisting at an approved school, required. * Working knowledge of medical terminology, CPT and ICD-9 coding , required Additional Details: + Ability… more
    Northwell Health (08/08/25)
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  • Fraud & Investigations, Clinical Investigator

    MVP Health Care (Rochester, NY)
    …preferred. + Obtain CPC and/or COC credential. + Maintain nursing license and coding credentials through continuing education process as required. + Superior ... to the above requirements: A duly licensed or authorized medical professional, including but not limited to MD or...knowledge of CPT-4, ICD-9-CM, ICD-10-CM, HCPCS and CPT Assistant coding guidelines as they relate to claim data. +… more
    MVP Health Care (08/31/25)
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  • Authorization Specialist Thoracic Surgery Office…

    Trinity Health (Syracuse, NY)
    …consistent with the mission and core values of St Peter's Health Partners Medical Associates. Job Duties * Submit and obtain authorization requests for service line. ... insurance policies while following all federal, state, and local medical policy guidelines. * Initiate Peer to Peer's with...➢ Preferred certification in CCS, CCS-P, CPC, or specialty coding . ➢ One to three years' experience in a… more
    Trinity Health (06/10/25)
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  • Accounts Receivable Representative

    Ellis Medicine (Schenectady, NY)
    …Review and resolve outstanding accounts receivable with insurance companies and patients. EDUCATION AND EXPERIENCE REQUIREMENTS: + Education : High School Diploma ... or healthcare setting preferred. + Must have knowledge of medical records, medical terminology and billing requirements,... terminology and billing requirements, CPT, HCPCS and ICD-9 coding and be able to apply such coding more
    Ellis Medicine (08/13/25)
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  • Claims Adjudicator

    Independent Health (Buffalo, NY)
    …healthcare related or social services setting; OR combination of experience. + Knowledge of medical billing procedures; CPT and ICD-9 coding and medical ... **Overview** The Claims Adjudicator is responsible for adjudicating and adjusting medical and/or dental claims against established criteria, and in accordance with… more
    Independent Health (08/29/25)
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  • Renewal and Reporting Analyst

    CVS Health (Albany, NY)
    …external partners. + Ability to utilize Meritain's proprietary system for analytical coding of detailed customized plans, rather than standard offerings. + Develops ... system setup and mapping of client level benefits to align with industry coding (ICD 10, place of service, healthcare reform, etc.), similar to entry-level IT… more
    CVS Health (08/30/25)
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  • Partner, US Field Access & Reimbursement - New…

    Astellas Pharma (Syracuse, NY)
    …services, programs, and offerings) to address challenges/opportunities. + Provide education on billing/ coding and reimbursement (for buy-and-bill products) ... world. We are committed to turning innovative science into medical solutions that bring value and hope to patients...for internal partners and assist in delivery of appropriate education . + Raise awareness of customer access and affordability… more
    Astellas Pharma (08/13/25)
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  • Referral & Authorization Specialist

    Glens Falls Hospital (Saratoga Springs, NY)
    …Specialist! This position can further develop your skills in compliance, medical billing, customer service, and Health Information Management (HIM)! If you ... 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 (07/02/25)
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