• 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 ... and potential to testify **Required Qualifications** + AAPC Coding certification - Certified Professional Coder (CPC) + 3+ years of experience in medical… more
    CVS Health (11/11/25)
    - Related Jobs
  • Special Investigation Unit Lead Review…

    CVS Health (Albany, NY)
    …to provide testimony if needed. + Experience with Excel. **Preferred Qualifications** + Certified Professional Coder + Knowledge of CVS/Aetna's policies and ... be work from home anywhere in the United States. **Position Summary** The Special Investigations Unit (SIU) is looking for an analytically driven individual who is… more
    CVS Health (11/19/25)
    - Related Jobs
  • Senior Investigator, Special Investigations…

    CVS Health (Albany, NY)
    …to travel approximately 10% of time for business purposes. **Preferred Qualifications** + Certified Professional Coder (CPC), AHFI, CFE + Knowledge of ... are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU), dedicated to a specific self-funded plan… more
    CVS Health (11/19/25)
    - Related Jobs
  • Investigator, Coding Special Investigative…

    Molina Healthcare (NY)
    …Association** Licensed registered nurse (RN), Licensed practical nurse (LPN) and/or Certified Coder (CPC, CCS, and/or CPMA) **Preferred Education** Bachelor's ... Certified Medical CPC, CPMA, CPCO or similar specialist preferred + Certified Fraud Examiner and/or AHFI professional designations preferred To all current… more
    Molina Healthcare (11/20/25)
    - Related Jobs
  • Compliance Auditing Specialist- Remote/Hybrid…

    WMCHealth (Valhalla, NY)
    …or more of the following credentials: Certified Risk Coder (CRC), Certified Professional Coder certification (CPC), Certified Professional ... credential(s). Education: Bachelor's Degree in related field Other: Remote/Hybridavailable Special Requirements: About Us: NorthEast Provider Solutions Inc. Benefits:… more
    WMCHealth (09/12/25)
    - Related Jobs
  • RN Medical Review Nurse Remote

    Molina Healthcare (Albany, NY)
    … Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), ... and support to clinical peers. + Identifies and refers members with special needs to the appropriate Molina program per applicable policies/protocols. **Job… more
    Molina Healthcare (12/03/25)
    - Related Jobs
  • Payment Integrity Clinician

    Highmark Health (Albany, NY)
    …Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** + Demonstrated ability ... SUMMARY** This job requires the ability to identify issues related to professional and facility provider claims data including determining appropriateness of code… more
    Highmark Health (11/14/25)
    - Related Jobs
  • Surgical Anesthesia 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 (11/08/25)
    - Related Jobs