• 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 (11/27/25)
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  • Collections Billing Associate

    KPH Healthcare Services, Inc. (Rochester, 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. (11/18/25)
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  • Medical Investigator I/II (RN Required)

    Excellus BlueCross BlueShield (Rochester, NY)
    …, CPT, HCPCS, ICD10, DRG, APC, RBRVS, etc.). + Extensive experience with claims processing systems, claims flow, adjudication process, system edits ... in a clear and concise manner. + Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns. + Manages cases as assigned,… more
    Excellus BlueCross BlueShield (09/17/25)
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  • VP, Medical Economics

    Molina Healthcare (Rochester, NY)
    …health care operations (utilization management, disease management, HEDIS quality measures, claims processing , etc.) * Advanced understanding on health care ... into actions/interventions to improve financial performance. * Advanced understanding of Medicaid and Medicare programs or other health care plans. * Advanced… more
    Molina Healthcare (11/21/25)
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