• Medical Director-Payment Integrity

    Humana (Albany, NY)
    …of decisions to internal associates. The clinical scenarios predominantly arise from inpatient or post-acute care environments. A remote possibility exists of ... level of care, and/or requested site of service should be authorized at the Inpatient level. All work occurs within a context of regulatory compliance, and work is… more
    Humana (09/26/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Rochester, NY)
    …Looking for a RN that has a current active unrestricted license This a remote role and can sit anywhere within the United States. Work Schedule Monday to ... for a RN with experience with appeals, claims review, and medical coding . **Job Summary** Utilizing clinical knowledge and experience, responsible for review of… more
    Molina Healthcare (09/06/25)
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  • Medical Director - Southeast Region

    Humana (Albany, NY)
    …participation in care management. The clinical scenarios predominantly arise from inpatient or post-acute care environments. Has discussions with external physicians ... require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient… more
    Humana (09/10/25)
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  • Patient Financial Services Analyst

    Garnet Health (Harris, NY)
    …years of extensive experience in revenue cycle, with a focus on hospital inpatient /outpatient billing and coding required. Experience with billing software such ... + Skills: In-depth knowledge of ICD, CPT, and HCPCS coding systems. Experience with Medicare, Medicaid, and commercial insurance...ventilated facility. No routine exposure to hazards. + For Remote and Hybrid Remote positions: If deemed… more
    Garnet Health (08/29/25)
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  • Revenue Cycle Analyst - Medical Group - E…

    Trinity Health (East Greenbush, NY)
    …is located at 2 Empite Drive East Greenbush, NY, and has the opportunity to work remote 1 day a week. . This Revenue Cycle Analyst is needed for the medical group. ... Coding and EPIC knowledge not required but a plus....to identify needed feedback to practice locations. + Process inpatient charges submitted by providers via interface tool or… more
    Trinity Health (09/03/25)
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  • Medical Director - Claims Management

    Humana (Albany, NY)
    …may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, dispute, grievance, and appeals processes, and ... post residency or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled… more
    Humana (09/17/25)
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