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Reimbursement Case Manager Jobs in Rochester, NY

Anders Group

Travel Nurse RN - Case Management

Webster, NY · On-site

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URMHC Level 2 CHHA Case Manager RN About Anders Group About Anders Group Why Anders? At Anders ... Licensure & CEU Reimbursement * Daily Per Diems & Travel Reimbursements * Rental Car Allowances

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How much do reimbursement case manager jobs pay per hour?

As of Aug 19, 2026, the average hourly pay for reimbursement case manager in Rochester, NY is $24.42, according to ZipRecruiter salary data. Most workers in this role earn between $18.99 and $26.54 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a reimbursement case manager?

To thrive as a Reimbursement Case Manager, you need a solid understanding of healthcare reimbursement processes, insurance policies, and medical billing, often supported by a background in nursing, social work, or healthcare administration. Familiarity with claims management systems, electronic health records (EHRs), and payer portals is typically required, and certifications like CCM (Certified Case Manager) can be advantageous. Strong communication, problem-solving, and organizational skills help you effectively advocate for patients and collaborate with providers and payers. These competencies ensure accurate reimbursement, compliance, and optimal patient outcomes in a complex healthcare environment.

How does a reimbursement case manager typically collaborate with healthcare providers and insurance companies to resolve patient billing issues?

Reimbursement Case Managers act as key liaisons between healthcare providers, patients, and insurance companies to ensure that claims are processed accurately and efficiently. They regularly communicate with medical staff to collect necessary documentation, clarify coding, and verify treatment details. Additionally, they work closely with insurance representatives to address denials, appeal decisions, and troubleshoot payment delays. This collaborative approach requires strong communication skills and a deep understanding of both clinical and insurance processes.

What is the difference between Reimbursement Case Manager vs Claims Specialist?

AspectReimbursement Case ManagerClaims Specialist
CredentialsTypically requires healthcare or insurance-related certificationsOften requires insurance or claims processing certifications
Work EnvironmentHealthcare facilities, insurance companies, or managed care organizationsInsurance companies, third-party administrators, or healthcare providers
Job FocusManaging reimbursement processes, verifying coverage, and resolving billing issuesProcessing claims, reviewing documentation, and ensuring accurate claim submission

Reimbursement Case Managers and Claims Specialists both work within the healthcare and insurance industries, focusing on financial aspects of patient care. While Reimbursement Case Managers primarily handle reimbursement processes and coverage verification, Claims Specialists concentrate on processing and reviewing insurance claims. Both roles require knowledge of insurance policies and healthcare billing, but their daily tasks and focus areas differ slightly.

What does a reimbursement case manager do?

A reimbursement case manager reviews and processes insurance claims and reimbursement requests, ensuring accuracy and compliance with policies. They communicate with clients, healthcare providers, and insurance companies, often using case management software, to resolve issues and facilitate timely payments.

What are popular job titles related to Reimbursement Case Manager jobs in Rochester, NY?

For Reimbursement Case Manager jobs in Rochester, NY, the most frequently searched job titles are:

What job categories do people searching Reimbursement Case Manager jobs in Rochester, NY look for?

The top searched job categories for Reimbursement Case Manager jobs in Rochester, NY are:

What cities near Rochester, NY are hiring for Reimbursement Case Manager jobs?

Cities near Rochester, NY with the most Reimbursement Case Manager job openings:

Reimbursement Case Manager jobs near you
Infographic showing various Reimbursement Case Manager job openings in Rochester, NY as of August 2026, with employment types broken down into 1% As Needed, 84% Full Time, 14% Part Time, and 1% Contract. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution, with an average salary of $50,821 per year, or $24.4 per hour.

Financial Case Manager

Rochester Regional Health

Rochester, NY • On-site

$20.75 - $27.25/hr

Full-time

Medical

Re-posted yesterday

Rochester Regional Health rating

7.3

Company rating: 7.3 out of 10

Based on 218 frontline employees who took The Breakroom Quiz

307th of 888 rated healthcare providers

Job description

Job Title: Financial Case Manager
Department: FCM Group 2
Location: Riedman Campus, 100 Kings Highway, Rochester, NY- 14610-0757.
Hours Per Week: 40
Schedule : Full-Time, Day Shift, Monday to Friday-8 hours shift
Position Summary:
The Financial Case Manager is responsible for reviewing uninsured and under-insured patient accounts by following the insurance verification process.
Community/Acute - The FCM will assist under-insured patients by interviewing patients and screening for secondary coverage options, applying for financial assistance and other government based programs. This person assists patients with setting up interest free payment plans and work closely with Patient Financial Services to help resolve minor coordination of benefits (COB) issues that include obtaining appeal documentation.
Long Term Care - The FCM will assist residents in applying for and recertifying in Medicaid coverage. This entails interviewing and screening resident and family for financial history, investigating and obtaining financial documentation needed from but not limited to banking institutions, financial markets including life insurance agencies, pension programs, and investment firms. This person will work closely with system and outside attorney agencies as well as the Department of Social Services.
All communication must be conducted in a manner that will result in positive patient relations and prompt reimbursement for services rendered. The FCM may also help in internal continuous improvement initiatives around financial performance. This individual works collaboratively with multiple departments of our organization
Key Responsibilities:
Financial Counseling
  • Assesses the healthcare coverage needs of uninsured and under-insured patients.
  • Verifies insurance coverage to identify uninsured patients who may be eligible for insurance enrollment, and provides the FCM II accurate information for patient interview when needed.
  • Assists under-insured patients with applying for secondary coverage, financial assistance applications in the acute care setting and other programs in which they be eligible.
  • Complete all financial and secondary insurance applications with high quality work, gathers all necessary documentation and submit them to the proper agency / staff for processing.
  • Notifies the appropriate staff of pertinent information and enters notes in a timely manner into the financial and clinical sections of Care Connect as well as any additional software programs that may be deemed necessary for the arena working in.
  • Establishes payment plan arrangements for patients per policy for hospital and clinical accounts.
  • Thorough knowledge of long term care Medicaid program including necessary forms, documentation requirements, agency regulations and budgeting procedures for Long Term Care arena.
  • Follows documentation and productivity standards according to policies and procedures.
  • Assists patients with resolving non-complex coordination of benefit issues. May need to contact third party insurance providers to rectify primary and secondary coverage errors.
  • Collaborate with Patient Financial Services staff by contacting patients requesting they complete appeal documentation for the acute based hospital accounts.
  • Track Private Pay residents in Long Term Care setting in order to begin Medicaid application at opportune time as to ensure no gap in coverage for nursing home.
  • Scanning and saving applications and decisions into system for future reference
  • Additional duties as assigned with a positive attitude.

Customer Service
  • Conveys courtesy, dignity, respect, and a positive attitude with all individuals.
  • Demonstrates kindness and empathy when interacting with patients, family and visitors and is able to anticipate the needs of the people we serve.
  • Collaborates with patients, their family/support person(s), State or County staff, and/or other agencies to ensure patients receive the coverage they are eligible for in a timely manner.

Quality
  • Ensure timely completion of release of information forms, patient financial information, financial obligations, and other applicable Rochester Regional Health forms per policy.
  • Verifies guarantor and resident information for accuracy.
  • Updates hospital and clinic accounts accurately with plan code and insurance information.
  • Ensure all accounts documented timely with accurate and complete information.
  • Maintains accurate spreadsheets and databases per department standards.
  • Completes organizational and state (NYS of Health) required training programs.
  • Ensures compliance with privacy and security standards per Rochester Regional Health policies and procedures.

Desired Attributes:
  • For Community/Hospital setting: Completion of the Certified Application Counselor (CAC) training within 6 months of employment.
  • Base knowledge of health care governmental assistance programs, guidelines, and application procedures.
  • Able to communicate and respond to inquiries; requires effective interpersonal skills and ability to interact with the patients to explain payment policies and persuade patients to settle account balances.
  • Ability to manage multiple concurrent assignments in a fast-paced environment.
  • Ability to utilize Care Connect system effectively and accurately upon initial completed training.
  • Skilled establishing priorities to complete work in a timely manner despite changes in workload, deadlines, or competing requirements.
  • Demonstrate strong interpersonal and organizational skills to interact courteously and effectively with physicians, patients, and staff members.
  • Ability to interact with all members of the organization in ways that enhance understanding, respect, cooperation and problem solving.
  • Writing and editing skills to prepare grammatically routine business correspondence; such as email and letters.
  • Skilled in operating a PC and PC-based software applications, including Microsoft Office.
  • Ability to solve problems with minimal direction in a stressful environment and maintain a positive attitude.
  • Demonstrate excellent time management, organizational, verbal, and written skills.
  • Ability to handle difficult situations involving patients, physicians, or others in a professional manner.
  • Ability to maintain confidentiality of all medical, financial, and legal information.
  • May need to travel throughout service area.

Minimum Qualifications:
  • Associates Degree in related field with two years of experience preferred or an equivalent combination of work experience in financial counseling, long term care setting, healthcare billing or customer/patient service is required.

Required Licensure/Certification Skills
  • None

Rochester General Health System is an Equal Opportunity / Affirmative Action Employer. Minority/Female/Disability/Veteran.
EDUCATION:
LICENSES / CERTIFICATIONS:
NYS DL - valid New York State Driver's License - New York State Department of Motor Vehicles (NYSDMV)New York State Department of Motor Vehicles (NYSDMV)New York State Department of Motor Vehicles (NYSDMV)
PHYSICAL REQUIREMENTS:
S - Sedentary Work - Exerting up to 10 pounds of force occasionally Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.
For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements.
Any physical requirements reported by a prospective employee and/or employee's physician or delegate will be considered for accommodations.
PAY RANGE:
$21.00 - $24.50
CITY:
Rochester
POSTAL CODE:
14617
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 determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.
Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.

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