• Medical Investigator I/II (RN Required)

    Excellus BlueCross BlueShield (Rochester, NY)
    …or desk audits, clinical reviews of medical records to ensure correct billing of services and appropriateness of care, interviewing potential witnesses, developing ... Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns. + Manages cases as assigned, prioritizing case load as… more
    Excellus BlueCross BlueShield (09/17/25)
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  • Senior Contract Manager Analyst - Mount Sinai…

    Mount Sinai Health System (New York, NY)
    …implementation and contract compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as ... role in testing, coding, modeling, and reporting on Hospital Billing (HB) and Professional Billing (PB) contracts for the MSHS Health System. This individual… more
    Mount Sinai Health System (10/29/25)
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  • Intake Manager

    Heath System Services (Niagara Falls, NY)
    …and manage the Intake team to ensure accurate and compliant order intake, billing , and insurance verification. This role requires strong technical skills to navigate ... of workflows. + Ensure timely and accurate handling of incoming orders. + Billing and Insurance Compliance: + Ensure all orders meet payer requirements, including… more
    Heath System Services (10/25/25)
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  • Principal, Stars Enterprise Activation - Insurance…

    Humana (Albany, NY)
    …Principal coordinates, implements, and manages oversight of the company's Medicare /Medicaid Stars Program for aligned areas. The Stars Improvement Principal ... Operations encompasses critical functions including care coordination, quality measurement, billing , claims processing, and customer service, each essential to… more
    Humana (11/19/25)
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  • Clinic Administrator

    The Arc Wayne (Newark, NY)
    …when coordinating service provision to individuals. + Responsible for timely and accurate billing of article 16 services. Acts as liaison to billing vendor. ... status and are identified as having a potential to bill to Medicare , require enrollment as a Medicare provider by obtaining and providing to Arc Wayne a National… more
    The Arc Wayne (11/15/25)
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  • Revenue Cycle Manager

    Insight Global (Syracuse, NY)
    …reviewing payor contracts to ensure contract fees are modeled accurately in the billing system and working with billing staff to identify variances in ... staff findings, and reports findings to leadership. Resolves complex physician professional billing issues in a timely manner. Leads and mentors revenue cycle… more
    Insight Global (11/26/25)
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  • Supervisor, Rehab Support Services - Full time…

    Mohawk Valley Health System (Utica, NY)
    …information. + Address claim denials, errors, or discrepancies in collaboration with the billing department. + Keep current in Medicare , Medicaid and insurance ... accurate patient data collection, efficient scheduling, chart documentation, timely billing processes, and the onboarding and training of new administrative… more
    Mohawk Valley Health System (11/19/25)
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  • Compliance Audit Manager

    Cardinal Health (Albany, NY)
    …and manages compliance audits to determine organizational integrity of billing for professional (physician) services and/or hospital (technical) services. This ... documentation and coding related to physician or hospital (inpatient and outpatient) billing and/or medical necessity reviews. + Prepares written reports of audit… more
    Cardinal Health (11/08/25)
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  • Venipuncture Tech Clin Support- Per Diem

    Stony Brook University (Stony Brook, NY)
    …policies and procedures to conform to regulatory agency mandates which ICD-10 CM billing codes, medical necessity and Medicare questionnaires. + Will assist all ... Patient Service Center. Phlebotomy and specimen collection facility. Registration, billing , order entry, patient and customer service, result reporting quality… more
    Stony Brook University (10/22/25)
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  • Credentialing Specialist HCS

    Catholic Health (Buffalo, NY)
    …basis + Request annual COI from clients and upload into CAQH + Complete Medicare and Medicaid re-validations when needed + Track when Medicare and Medicaid ... phone call from Insurances, providers, client managers, practice and billing staff + Respond to numerous emails from clients,...Respond to numerous emails from clients, insurances, office and billing staff + Research requests from office and … more
    Catholic Health (09/20/25)
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