• Care Manager Transition of Care

    Centene Corporation (East Syracuse, NY)
    …activities to ensure compliance with current state, federal, and third-party payer regulations + Provides feedback to leadership on opportunities to improve ... and enhance care and quality delivery for members in a cost-effective manner + Other duties or responsibilities as assigned by people leader to meet business needs + Performs other duties as assigned + Complies with all policies and standards Must reside in… more
    Centene Corporation (07/25/25)
    - Related Jobs
  • Billing Auditor for Shared Services

    Planned Parenthood of Central and Western NY (Rochester, NY)
    …accuracy, and completeness of encounters, claims and transactions in compliance with payer rules and regulations + Maintains and ensures a disciplined and effective ... approach to discover root causes of denials, underbilling, overbilling, underpayment, and aging A/R + Reports to Revenue Cycle Management, Affiliate HS/RC Monthly meetings, and Quality Risk Management Committees on trends, findings, and opportunities for… more
    Planned Parenthood of Central and Western NY (07/25/25)
    - Related Jobs
  • Care Facilitator- Per Diem- Canton-Potsdam…

    Rochester Regional Health (Rochester, NY)
    …champions service excellence. Facilitates assignment of level of care, considers payer requirements and responds accordingly to avoid adverse financial consequence ... to patient and hospital. Provide superior customer service by modeling the Brand Promise and Core Values.RESPONSIBILITIES: + Conducts clinical reviews utilizing objective criteria (Interqual) to assign patient to the appropriate level of care; identifies… more
    Rochester Regional Health (07/25/25)
    - Related Jobs
  • Denials Assistant - Patient Financial Services

    Saratoga Hospital (Saratoga Springs, NY)
    …teams. Manage incoming voicemail and responds to patient, health insurance and payer vendors' queries as appropriate. + Assists with Denials team clerical tasks, ... including receiving and routing of incoming faxes and documents, entering data into the EMR system, assisting in compiling appeals and reconsiderations. + Collaborate and communicate effectively with employees and PFS leadership to ensure any policies and… more
    Saratoga Hospital (07/25/25)
    - Related Jobs
  • Chargemaster Analyst II

    Intermountain Health (Albany, NY)
    …related functions. This position is adept with Federal, State, CMS-OPPS, and regulatory/ payer requirements and will update the chargemaster as needed. This position ... will train and mentor teammates, provide education and guidance to revenue cycle and clinical teams, and assists with testing and validation. Supports and collaborates with revenue producing departments, business office, revenue practice teams, HIM, managed… more
    Intermountain Health (07/25/25)
    - Related Jobs
  • Case Manager (Inpatient Units)

    Ellis Medicine (Schenectady, NY)
    …utilization review, and discharge planning experience highly preferred. Home care, payer , or other experience will be considered. SECTION III PHYSICAL REQUIREMENTS: ... The position is located indoors and has community responsibilities in which the incumbent is required to attend. Should be able to push/pull 35 lb., lift/move 15 lb. from floor to table, be able to perform moderately difficult manual manipulations such as… more
    Ellis Medicine (07/25/25)
    - Related Jobs
  • Radiation Oncology Financial Authorization…

    Mount Sinai Health System (New York, NY)
    …or private payers regarding coverage for services. 2. Obtains all necessary payer authorizations and acquires all required referrals for services to be provided. ... 3. Negotiates modifies rates with carriers. 4. Communicates and inform patients of any potential patient out-of-pocket liability, and works out payment plans as necessary. May provides resources to bridge the gap between insurance coverage and patients… more
    Mount Sinai Health System (07/25/25)
    - Related Jobs
  • Sr. Applications Support Specialist

    Fujifilm (Albany, NY)
    …for proper billing, coding, and collection under current commercial and federal payer rules for local environment. + Develops project summary documents such as ... workflow diagrams, site profile summaries, and Compiles data on specific functions, as required. + Manages client expectations to ensure customer satisfaction. This position can include both implementation as well as post go live follow up. + Identifies… more
    Fujifilm (07/24/25)
    - Related Jobs
  • Sr Specialist, Credentialing, Network and Payor…

    Cardinal Health (Albany, NY)
    …entire network of participating health plans + Cultivate and maintain on-going payer relationships and Medicaid enrollments. + Adhere to cyclical renewal, retrieval, ... and updates per profile + Work closely with third party vendors to identify data needs and execute updates when required + Report results and outcomes of network status to management at regular intervals + Respond to third party/managed care requests in a… more
    Cardinal Health (07/24/25)
    - Related Jobs
  • Radiology Coder

    SUNY Upstate Medical University (Syracuse, NY)
    …and HCPCS codes. + Ensure compliance with current healthcare regulations and payer requirements. + Prepare and submit claims to insurance companies, following up ... on unpaid or denied claims. + Collaborate with healthcare providers to clarify diagnoses and obtain additional information. + Maintain patient confidentiality and adhere to HIPAA guidelines. + Hybrid work available: 1-2 work days from home and 3-4 work days in… more
    SUNY Upstate Medical University (07/24/25)
    - Related Jobs