• Utilization Manager Reviewer, RN (Multiple…

    Excellus BlueCross BlueShield (Rochester, NY)
    …for members in obtaining needed services, as appropriate, interacts with the treating physician or other providers of care. + Collaborates with hospital, home care, ... and State and Federal Mandates. + May be responsible for pricing, coding , researching claims to ensure accurate application of contract benefits and Corporate… more
    Excellus BlueCross BlueShield (08/23/25)
    - Related Jobs

  • Billing Coordinator - Accounts Receivable-MSH

    Mount Sinai Health System (New York, NY)
    …referring physician updates and other major dictionary requests to supervisor for approval. 10. Maintains strictest confidentiality; adheres to all HIPAA and ... 2 years healthcare billing experience required. Familiarity with CPT and ICD ( coding and CCI edits) + Electronic claims processing preferred. **Responsibilities** 1.… more
    Mount Sinai Health System (09/17/25)
    - Related Jobs

  • Lead Patient Access Specialist MHB

    Catholic Health (Buffalo, NY)
    …Medical terminology background and strong insurance background required. Knowledge of ICD-10 coding , physician orders, medical necessity ABN regulations + Must ... of all Patient Access Services. The Lead Patient Access associate assists the supervisor in ensuring that the associates adhere to department, Hospital and Catholic… more
    Catholic Health (09/28/25)
    - Related Jobs

  • Senior Provider Relations Representative

    Molina Healthcare (Buffalo, NY)
    …they arise, making an assessment when escalation to a Senior Representative, Supervisor , or another Molina department is needed. Takes initiative in preventing and ... related to utilization management, pharmacy, quality of care, and correct coding . * Independently delivers training and presentations to assigned providers and… more
    Molina Healthcare (09/25/25)
    - Related Jobs

  • Radiology Technologist - PT

    STG International (Watertown, NY)
    …in the computer before advancing to the next exam. * Supports CPT coding compliance; utilizes appropriate CPT codes for the exams performed. Ensures images are ... to patients or their families. Patients will be referred to their requesting physician for results and treatment planning. * Ensures modesty and comfort is observed… more
    STG International (09/25/25)
    - Related Jobs

  • Clm Resltion Rep II, Hosp/Prv

    University of Rochester (Rochester, NY)
    …Receivable Management. **ESSENTIAL FUNCTIONS** **_With general direction of the Manager/ Supervisor /Lead:_** 40% + Follows department policies and procedures and ... necessary to ensure balance resolution for all assigned URMFG physician services. 25% + Follows up on denied accounts...changes in billing requirements associated with claim processing and coding . 5% + Escalate issues that may prevent completion… more
    University of Rochester (09/24/25)
    - Related Jobs

  • Provider Relations Representative

    Independent Health (Buffalo, NY)
    …Representative will answer incoming calls from health care providers including physician offices, ancillary provider offices and facilities and aid with benefit ... Strong working knowledge of CPT, ICD-9-CM, ICD-10-CM and HCPCS coding preferred. + Experience in compliance regulations, appeals and...of health standards. + Escalate issues as needed to supervisor . + Log all contacts into appropriate systems and… more
    Independent Health (08/15/25)
    - Related Jobs