• Revenue Integrity Charge Specialist Fully Remote

    Trinity Health (Syracuse, NY)
    …and Medicare coding guidelines. Ensures medical documentation and coding compliance with Federal, State and Private payer regulations. Performs coding functions, ... for balancing charges and adjustments Maintains productivity standards Maintains compliance with regulatory requirements Responsible for denial coordination with… more
    Trinity Health (08/02/25)
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  • Representative, Provider Relations HP (Must Reside…

    Molina Healthcare (NY)
    …Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Provider Relations ... satisfaction, issue intake, access/availability and ensuring knowledge of and compliance with Molina healthcare policies and procedures while achieving the… more
    Molina Healthcare (08/02/25)
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  • Revenue Integrity Charge Specialist Fully Remote

    Trinity Health (Syracuse, NY)
    Medicare coding guidelines. Ensures medical documentation and coding compliance with Federal, State and Private payer regulations.Performs coding functions, ... claim submissionResponsible for balancing charges and adjustmentsMaintains productivity standardsMaintains compliance with regulatory requirementsResponsible for denial coordination with Patient… more
    Trinity Health (08/02/25)
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  • Sr Specialist, Credentialing, Network and Payor…

    Cardinal Health (Albany, NY)
    …pertain to services provided by the Company. This includes supporting and demonstrating compliance with the Company's Compliance and HIPAA Plans. + Promptly ... and ensure accuracy of public information materials. + Attend all required Compliance , HIPAA and other scheduled training. **_Qualifications_** + Bachelors degree or… more
    Cardinal Health (07/24/25)
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  • Manager Environmental Safety & Emergency…

    Mohawk Valley Health System (Utica, NY)
    …planning, 24/7 oversight of incident and event response and regulatory compliance . Core Job Responsibilities + Conduct an annual hazard vulnerability assessment ... grant contract requirements. + Develop policies and procedures that facilitate compliance and program implementation. + Ensure the facility meets all standards… more
    Mohawk Valley Health System (07/09/25)
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  • Clinical Accreditation Specialist - Aomc Qmpi

    Arnot Health (Elmira, NY)
    …interpretation of regulatory standards, including The Joint Commission and Centers for Medicare and Medicaid Services (CMS); ensures a constant state of readiness; ... leadership and assistance to enterprise-wide initiatives. Performance Improvement and Compliance : Duties and Responsibilities: ** 1. Assumes the daily organizational… more
    Arnot Health (06/25/25)
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  • Manager Enrollment and Billing

    Healthfirst (NY)
    …and terminations. + Collaborate with internal teams (eg, sales, customer service, compliance ) to ensure seamless management of members. + Monitor ,report, and ... ensures core Enrollment and Billing activities are managed in compliance with State and CMS guidelines and to ensure...and Knowledge of NY lines of business such as Medicare NY, Medicaid, Child Health Plus, QHP, EP, HARP… more
    Healthfirst (06/10/25)
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  • Rehabilitation Counselor 2

    New York State Civil Service (Queens Village, NY)
    …and referrals that are written by the rehabilitation staff, assuring compliance with recordkeeping requirements and standards.* Screen, evaluate, and approve all ... and experiences and the impact upon the rehabilitation process. *Assure compliance with recordkeeping requirements and standards.* Match and assign patients to… more
    New York State Civil Service (08/23/25)
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  • Utilization Manager Reviewer, RN (Multiple…

    Excellus BlueCross BlueShield (Rochester, NY)
    …of physical health (PH) medical and healthcare services for members, ensuring compliance with internal and external standards set by regulatory and accreditation ... specific health plan benefits, and efficient care delivery processes. Ensures compliance with corporate and departmental policy and procedure, identifies and refers… more
    Excellus BlueCross BlueShield (08/23/25)
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  • Associate Director Finance Technology Solutions

    Humana (Albany, NY)
    …performance, data integrity, and security through rigorous governance and proactive compliance practices. + Build a best-in-class Finance data and analytics function ... build stakeholder alignment, and drive innovation. + Familiarity with compliance standards, Finance data governance, and system audit-readiness. **Preferred… more
    Humana (08/22/25)
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