• Referral Coordinator-Hybrid/ Remote

    Trinity Health (Rensselaer, NY)
    …problem solves, communicates, and coordinates referral appointments with patient, physician (s), specialists and/or central scheduling. - Collaborates with essential ... decisions to patient. - Conducts follow up calls as necessary to physician offices, patients and payers to complete pre-certification process. Care Coordination -… more
    Trinity Health (08/20/25)
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  • Clinical Denials & Appeals Specialist…

    Northwell Health (Melville, NY)
    …and knowledge gaps. Job Responsibility Serves as liaison between the patient and facility/ physician and the third party payer. Prepares and defends level of care and ... medical necessity for assigned case. Collaborates with physician advisor, payor representative and site case managers to facilitate appropriate level of care… more
    Northwell Health (08/20/25)
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  • Manager, Medical Economics (Medicaid)…

    Molina Healthcare (Syracuse, NY)
    …medical facilities, healthcare vendor, commercial health insurance company, large physician practices, managed care organization, etc.) + Strong Knowledge of ... SQL and PowerBI report development + Familiar with relational database concepts, and SDLC concepts **Preferred Education** Masters' Degree in Finance, Economics, Math, Computer Science, Information Systems, or related field. **Preferred Experience** + 3 - 5… more
    Molina Healthcare (08/27/25)
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  • Risk Adjustment Coding Specialist ( Remote

    CDPHP (Latham, NY)
    …for a rewarding career. Established in 1984, CDPHP is a physician -founded, member-focused, and community-based not-for-profit health plan that offers high-quality ... affordable health insurance to members throughout New York. The company values people, quality, innovation, and community, and its corporate culture supports those values wholeheartedly. CDPHP is committed to fostering a culture of belonging and takes a… more
    CDPHP (08/27/25)
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  • Certified Coder (Risk Adjustment/Outpatient…

    Molina Healthcare (Syracuse, NY)
    …+ Certified Professional Payer - Payer (CPC-P) + Certified Coding Specialist - Physician based (CCS-P) To all current Molina employees: If you are interested in ... applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $21.16 - $46.42 / HOURLY *Actual… more
    Molina Healthcare (08/21/25)
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  • $70/hr Remote SLP Position

    Amergis (Fayetteville, NY)
    …with the plan of care developed for each individual student and the physician 's orders. Minimum Requirements: + Active Speech Language Pathologist (SLP) Licensure in ... the state of assignment required + Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP) preferred and may be required by state/contract. + Complies with all relevant professional standards of practice + Current CPR if applicable + TB… more
    Amergis (08/16/25)
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  • Diabetes Care and Education Specialist…

    Rochester Regional Health (Rochester, NY)
    …Any physical requirements reported by a prospective employee and/or employee's physician or delegate will be considered for accommodations. PAY RANGE: $63,000.00 ... - $85,000.00 CITY: Rochester POSTAL CODE: 14607 The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is… more
    Rochester Regional Health (08/13/25)
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  • Lead Abstractor, HEDIS/Quality Improvement…

    Molina Healthcare (Buffalo, NY)
    …as required by specifications. + Assists the quality improvement staff with physician and member interventions and incentive efforts as needed through review of ... medical records documentation. + Assists as needed in support of accreditation activities such as NCQA reviews, CAHPS and state audits by reviewing clinical documentation. + Provides data collection, presentations and report development support for quality… more
    Molina Healthcare (08/08/25)
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  • Medical Claims Adjudication - remote

    Cognizant (Albany, NY)
    …minimum of 2 years' claims processing experience is required. + Knowledge of physician practice and hospital coding, and medical terminology, CPT, HCPCA, ICD-10 + ... Experience making payments with UB/institutional (CMS-1450) and/or professional (CMS 1500) claims. + Knowledge of Medicare/Medicaid payment and coverage guidelines and regulations. + Must be able to work with minimal supervision. + 1 year of Facets experience.… more
    Cognizant (08/01/25)
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  • Psychiatric Nurse Practitioner, PMHNP-BC (NY State…

    aptihealth (NY)
    …achieve success. We provide an easy-to-use platform and tools to fully integrate physician and prescriber care. You will use your clinical proficiency, along with ... the aptihealth platform to deliver the best possible outcomes. Be part of a company that is uniquely connecting members with mental health professionals to ultimately impact the lives of millions. If you have a passion for innovation, implementation, and… more
    aptihealth (07/25/25)
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