• Certified Professional Coder…

    CVS Health (Albany, NY)
    …And we do it all with heart, each and every day. **Position Summary** The Certified Professional Coder (CPC) will perform medical claim reviews to ensure ... for meetings and potential to testify **Required Qualifications** - AAPC Coding certification - Certified Professional Coder (CPC). - 3+ years of experience… more
    CVS Health (09/10/25)
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  • Senior Analyst, Special Investigative Unit

    CVS Health (Albany, NY)
    …internet research. + Ability to Travel for Business purposes. **Preferred Qualifications** + Certified Professional Coder (CPC), AHFI, CFE + Bilingual ... Fraud Investigator to join our Dental/Pharmacy/Broker Investigative Team within Aetna's Special Investigations Unit. In this role, you will manage complex… more
    CVS Health (09/02/25)
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  • Coding Auditor Educator

    Highmark Health (Albany, NY)
    …Technician (RHIT), Certified Coding Specialist (CCS) + AAPC Credentials (Outpatient): Certified Professional Coder (CPC), Certified Outpatient ... of new staff, performing audits and research related to special projects and providing coverage for coding manager(s). (10%)...Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital… more
    Highmark Health (08/08/25)
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  • Professional Coding Educator/Auditor

    Premier Medical Group of the Hudson Valley (Poughkeepsie, NY)
    …related experience in a healthcare setting, with 2 years experience in auditor role. Certified Professional Coder (AAPC, AHIMA)- Required Certified ... JOB TITLE: Professional Coding Educator/Auditor DEPARTMENT: Billing Department STATUS: Full...predictable attendance. + May be asked to assist with special projects. + Maintain and model Premier Medical Groups… more
    Premier Medical Group of the Hudson Valley (06/13/25)
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  • Investigator

    Highmark Health (Albany, NY)
    …+ None **Preferred** (any of the following) + Certified Fraud Examiner (CFE) + Certified Professional Coder (CPC) + Certified Outpatient Coder ... for the field investigative work necessary to complete a review of a special project, potential fraud, waste and abuse case, conducting the initial investigations… more
    Highmark Health (09/10/25)
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  • Operations Reconciliation Analyst

    Nuvance Health (Poughkeepsie, NY)
    …BACHELOR'S LVL DGRE *Other Information:* . Bachelor's Degree or equivalent experience . Certified Professional Coder (CPC) preferred .Five (5) years relevant ... initiatives 13. Actively participates in all Revenue Cycle related special projects as well as daily, monthly and yearly...expectations relate to complete, timely, and accurate work products Certified Professional Coder (CPC) HFMA… more
    Nuvance Health (07/08/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Rochester, NY)
    … Certified Clinical Coder , Certified Medical Audit Specialists, Certified Case Manager , Certified Professional Healthcare Management, ... and support to clinical peers. + Identifies and refers members with special needs to the appropriate Molina Healthcare program per policy/protocol. **JOB… more
    Molina Healthcare (09/06/25)
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  • Compliance Auditor (Medical Billing and Coding),…

    FlexStaff (Chappaqua, NY)
    …Chappaqua, NY. Qualifications: * _Must possess a Professional Certification such as Certified Professional Coder or equivalent._ * Proven experience in ... and seeking clarification from providers.* Support the Compliance Officer with special requests, including Case Logs, guidance to the Clerical department, and… more
    FlexStaff (08/26/25)
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  • Medical Compliance Auditor

    FlexStaff (Chappaqua, NY)
    …In this pivotal role, you'll leverage your healthcare environment experience-whether as a Certified Professional Coder or similar professional -to audit ... in ancillary systems to resolve overlapping times and billing issues - Support special requests for case logs, documentation, and records for anesthesia services as… more
    FlexStaff (08/16/25)
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  • Claims Specialist Temp- FlexStaff

    Northwell Health (New York, NY)
    … projects and performs other duties as assigned QUALIFICATIONS: Education: Bachelor's degree. Certified Professional Coder (a plus) Experience: + Eight or ... more years of insurance experience within a healthcare or managed care setting (preferred) + Claims adjudication experience + Knowledge of MLTC/ Medicaid/Medicaid benefit + Knowledge of Member (Subscriber) enrollment & billing + Knowledge of Utilization… more
    Northwell Health (08/23/25)
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