• Medicaid Claims Processing…

    MVP Health Care (Rochester, NY)
    …requires innovative thinking and continuous improvement. To achieve this, we're looking for a Claims Examiner to join #TeamMVP. If you have a passion for medical ... claims and attention to detail this is the opportunity...York** **Qualifications you'll** **bring:** + High School Diploma required. Associate degree in health, Business or related field preferred… more
    MVP Health Care (11/12/25)
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  • HCPR Reimbursement Claims Processing…

    Humana (Albany, NY)
    …a part of our caring community and help us put health first** The Claims Processing Representative 2 adjudicates pharmacy claims and processes pharmacy ... support assignments. Performs computations. Typically works on semi-routine assignments. The Claims Processing Representative 2 determines whether to return,… more
    Humana (11/12/25)
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  • Associate Analyst, Claims Research

    Molina Healthcare (Rochester, NY)
    … claims issues. This role requires a keen understanding of medical claims processing , strong analytical skills, and the ability to effectively triage ... or team for further research or correction. + Leverages knowledge of claims processing workflows, billing practices, and regulatory guidelines to provide… more
    Molina Healthcare (10/18/25)
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  • Specialist, Claims Recovery (Remote)

    Molina Healthcare (Yonkers, NY)
    **JOB DESCRIPTION** **Job Summary** Responsible for reviewing Medicaid , Medicare, and Marketplace claims for overpayments; researching claim payment guidelines, ... tools such as DSHS and Medicare billing guidelines, Molina claims ' processing policies and procedures, and other...of 1 year experience in healthcare insurance environment with Medicaid , or Managed Care + Strong verbal and written… more
    Molina Healthcare (11/03/25)
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  • Supervisor, Claims Review

    Humana (Albany, NY)
    …or team lead role. **Knowledge & Skills:** + Solid understanding of claims processing , insurance guidelines, and provider data interpretation. + Familiarity ... a part of our caring community and help us put health first** The Supervisor, Claims Review makes appropriate claim decision based on strong knowledge of claims … more
    Humana (11/12/25)
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  • Senior Process Improvement Professional

    Humana (Albany, NY)
    …for proposed new benefits, with 64 feasibility notifications processed in 2024. ** Medicaid State Claims Processing Support** + Provides specialized ... are key to getting the job done. **Key Responsibilities:** **Natural Disaster and Cyber Event Claims Processing ** + This role manages all initial claims … more
    Humana (11/08/25)
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  • Collections Billing Associate

    KPH Healthcare Services, Inc. (East Syracuse, NY)
    …Care, and private billing, claim corrections and follow-up + Track and re-bill pending Medicaid accounts + Re-bill claims as needed + Identify pattern problems ... **Overview** **Scope of Responsibilities** : The Administration Billing Associate is responsible for identifying, researching, rectifying, and maintaining accurate… more
    KPH Healthcare Services, Inc. (09/23/25)
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  • Administrative Support Associate VI…

    Albany Medical Center (Albany, NY)
    …school education or equivalent + 1-2 years of experience in medical billing or medical claims processing + Working knowledge in Excel and Word + Ability to work ... credits - Complete daily review of patient accounts that are pending NYS Medicaid and/or Charity Care status - Complete monthly rejections categorized as eligibility… more
    Albany Medical Center (09/16/25)
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  • Senior Billing Specialist

    Access: Supports For Living (Middletown, NY)
    …identified revenue cycle billing issues + Handling billing cycle review procedures for pre- processing (scrubbing) of weekly claims processing + Analyze, ... billing and processing program claims for accuracy and completeness; submit claims ...+ Maintain a working knowledge of OMH, OASAS, Medicare, Medicaid , Medicaid Managed Care and other payers'… more
    Access: Supports For Living (10/18/25)
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  • Encounter Data Management Professional

    Humana (Albany, NY)
    …and other resources to provide insight and ensure data integrity for Medicare/ Medicaid claims errors. **Key Role Functions** + Develop business processes ... data to Medicaid and Medicare through effective business processes. Ensures claims submissions meet or exceed all compliance standards via analysis of data and… more
    Humana (11/08/25)
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