Certified Professional Coder, Special Investigations Unit (Aetna SIU) CVS Health CorpCertified Professional Coder, Special Investigations Unit (Aetna SIU)PA$43,888–$102,081 / yearThe Certified Professional Coder (CPC) will perform medical claim reviews to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do.
Sr Compliance Audit & Education Specialist Temple University Health SystemSr Compliance Audit & Education SpecialistPhiladelphia, PAResponsible for the orientation and continuing education of Temple Physicians related to proper code usage, documentation deficiencies, carrier guidelines, creation of billing tools and HIPAA and Privacy guidelines. 5 years experience in medical coding (physician), billing and coding auditing, compliance, clinical documentation and coding training required.
NewClaim Benefit Specialist CVS Health CorpClaim Benefit SpecialistPA$17–$28.46 / hourAnalyzes claims data and generate reports to identify trends, patterns, or areas for improvement to help inform process enhancements, policy changes, or training needs within the claims processing department. Performs claim documentation review, verifies policy coverage, assesses claim validity, communicates with healthcare providers and policyholders, and ensures accurate and timely claims processing.
Medicaid Billing Administrator - Intern (Unpaid) Neuropath Healthcare SolutionsMedicaid Billing Administrator - Intern (Unpaid)Cherry Hill, New JerseyAt Neuropath Healthcare Solutions, we provide comprehensive technology-driven healthcare solutions for healthcare organizations, including hospitals, long-term care, outpatient facilities, and residential treatment. The Medicaid Billing Administrator Internship at Neuropath Behavioral Healthcare is designed to provide students and recent graduates with practical training and exposure to healthcare billing processes.
Medical Biller, SNF US Career PartnersMedical Biller, SNFNew JerseyAs a Medical Biller, you will be responsible for accurately and efficiently processing medical claims and ensuring timely reimbursement for services rendered. Company Overview: Our client is a leading SNF finance company that provides financial solutions to skilled nursing facilities across the country.
Medical Auditor - Remote YO AI LabsMedical Auditor - RemotePhiladelphia, PennsylvaniaRemoteWe are seeking experienced Medical Auditors to contribute their specialized expertise to an innovative healthcare AI project. This opportunity is ideal for professionals with strong experience in outpatient professional fee coding, auditing, and academic medical center environments.
Medical Office Manager - Pennsylvania The Dermatology SpecialistsMedical Office Manager - PennsylvaniaPhiladelphia, PennsylvaniaKnowledge of health insurance policies, guidelines- including copays, coinsurances, referrals, verification of insurances; handling patients' records discretely, updating demographic and financial information; Protecting and securing medical records. Program graduates are guaranteed a position to join our clinical team, creating a clear pathway from education to long-term career growth with us.
Medical Director, Payment Integrity - Remote (PA/NJ/DE) Blue Cross and Blue Shield AssociationMedical Director, Payment Integrity - Remote (PA/NJ/DE)Philadelphia, PARemoteRepresent the organization in executive-level meetings, Joint Value Committees (JVCs), Joint Operating Committees (JOCs), and other provider forums to discuss payment accuracy, utilization trends, quality outcomes, claim reviews, disputes, appeals, and improvement opportunities. Collaborate with Utilization Management Medical Directors, Quality Clinical Leaders, Network Management, Provider Relations, Analytics, Legal, Compliance, and Operational teams to align payment integrity activities, reimbursement policies, medical necessity determinations, and provider communications.
NewClaim Benefit Specialist- Commercial Operations CVS Health CorpClaim Benefit Specialist- Commercial OperationsPA$17–$28.46 / hourPerforms claim documentation review, verifies policy coverage, assesses claim validity, communicates with healthcare providers and policyholders, and ensures accurate and timely claims processing. Analyzes claims data and generate reports to identify trends, patterns, or areas for improvement to help inform process enhancements, policy changes, or training needs within the claims processing department.
Sr. Collections Associate Generis Tek Inc.Sr. Collections AssociatePhiladelphia, PA$25–$30 / hourResolve patient insurance balances by analyzing denials and using critical thinking skills and knowledge of payer requirements to determine the steps needed to obtain payment. -Follow workflows to route accounts to other client departments (Case Management, Medical Records, Credit Resolution, Billing, Abstraction, Clinical Teams, Coding etc.) to address denials.
Coder - Physician Practice - CPC Required Virtua Health IncCoder - Physician Practice - CPC RequiredMount Laurel, NJRemote$26–$39.11 / hourWe assembled more than 14,000 colleagues, including over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques to provide exceptional care close to home. That means bringing life-changing resources and health services directly into our communities through our Eat Well food access program, telehealth, home health, rehabilitation, mobile screenings, paramedic programs, and convenient online scheduling.
Charge Audit Analyst Sutter HealthCharge Audit AnalystTrenton, NJ$42.41–$63.62 / hourPosition Overview: Responsible for activities which improve the accuracy of facility outpatient clinical documentation coding and charging, including education with the clinical departments and coding staff and root cause correction to support accurate charging and coding in compliance with policies. Demonstrated ability to utilize official coding/billing resources including CPT/HCPCS references, OPPS Manual, NCCI Manual, NUBC Manual, etc. to determine applicable charges/codes as documented in the health record.
NewField Reimbursement Manager, Greensboro NC - Dermatology Johnson & JohnsonField Reimbursement Manager, Greensboro NC - DermatologyTitusville, NJRequired Skills: Preferred Skills: Account Management, Coaching, Competitive Landscape Analysis, Compliance Management, Consulting, Cross-Functional Collaboration, Escalation Management, Fact-Based Decision Making, Finance and Accounting Platforms, Financial Reports, Market Access Reimbursement, Market Opportunity Assessment, Performance Measurement, Pricing Strategies, Process Improvements, Strategic Thinking, Technical Credibility. The Field Reimbursement Manager (FRM) is responsible for serving as the primary field-based lead for education, assistance, and issue resolution with healthcare providers (HCPs), and their office staff, with respect to patient access to J&J Immunology therapies.
NewField Reimbursement Manager, Charlotte NC - Dermatology Johnson & JohnsonField Reimbursement Manager, Charlotte NC - DermatologyTitusville, NJRequired Skills: Preferred Skills: Account Management, Coaching, Competitive Landscape Analysis, Compliance Management, Consulting, Cross-Functional Collaboration, Escalation Management, Fact-Based Decision Making, Finance and Accounting Platforms, Financial Reports, Market Access Reimbursement, Market Opportunity Assessment, Performance Measurement, Pricing Strategies, Process Improvements, Strategic Thinking, Technical Credibility. The Field Reimbursement Manager (FRM) is responsible for serving as the primary field-based lead for education, assistance, and issue resolution with healthcare providers (HCPs), and their office staff, with respect to patient access to J&J Immunology therapies.
NewField Reimbursement Manager, Neuroscience - (Salt Lake City, UT) - Patient Engagement & Customer Solutions (PECS) Johnson & JohnsonField Reimbursement Manager, Neuroscience - (Salt Lake City, UT) - Patient Engagement & Customer Solutions (PECS)Titusville, NJRequired Skills: Preferred Skills: Account Management, Analytical Reasoning, Competitive Landscape Analysis, Compliance Management, Cross-Functional Collaboration, Developing Others, Fact-Based Decision Making, Inclusive Leadership, Leadership, Market Access Reimbursement, Market Opportunity Assessment, Operational Excellence, Performance Measurement, Pricing Strategies, Relationship Building, Strategic Thinking, Team Management. The Field Reimbursement Manager (FRM) is responsible for serving as the primary field-based lead for education, assistance, and issue resolution with healthcare providers (HCPs) and their office staff, with respect to patient access to J&J Neuroscience therapies.
NewField Reimbursement Manager, Neuroscience - (Atlanta, GA) - Patient Engagement & Customer Solutions (PECS) Johnson & JohnsonField Reimbursement Manager, Neuroscience - (Atlanta, GA) - Patient Engagement & Customer Solutions (PECS)Titusville, NJRequired Skills: Preferred Skills: Account Management, Analytical Reasoning, Competitive Landscape Analysis, Compliance Management, Cross-Functional Collaboration, Developing Others, Fact-Based Decision Making, Inclusive Leadership, Leadership, Market Access Reimbursement, Market Opportunity Assessment, Operational Excellence, Performance Measurement, Pricing Strategies, Relationship Building, Strategic Thinking, Team Management. The Field Reimbursement Manager (FRM) is responsible for serving as the primary field-based lead for education, assistance, and issue resolution with healthcare providers (HCPs) and their office staff, with respect to patient access to J&J Neuroscience therapies.
NewField Reimbursement Manager, Neuroscience - (San Antonio, TX) - Patient Engagement & Customer Solutions (PECS) Johnson & JohnsonField Reimbursement Manager, Neuroscience - (San Antonio, TX) - Patient Engagement & Customer Solutions (PECS)Titusville, NJRequired Skills: Preferred Skills: Account Management, Analytical Reasoning, Competitive Landscape Analysis, Compliance Management, Cross-Functional Collaboration, Developing Others, Fact-Based Decision Making, Inclusive Leadership, Leadership, Market Access Reimbursement, Market Opportunity Assessment, Operational Excellence, Performance Measurement, Pricing Strategies, Relationship Building, Strategic Thinking, Team Management. The Field Reimbursement Manager (FRM) is responsible for serving as the primary field-based lead for education, assistance, and issue resolution with healthcare providers (HCPs) and their office staff, with respect to patient access to J&J Neuroscience therapies.
NewField Reimbursement Manager, Neuroscience - (Manchester, NH) - Patient Engagement & Customer Solutions (PECS) Johnson & JohnsonField Reimbursement Manager, Neuroscience - (Manchester, NH) - Patient Engagement & Customer Solutions (PECS)Titusville, NJRequired Skills: Preferred Skills: Account Management, Analytical Reasoning, Competitive Landscape Analysis, Compliance Management, Cross-Functional Collaboration, Developing Others, Fact-Based Decision Making, Inclusive Leadership, Leadership, Market Access Reimbursement, Market Opportunity Assessment, Operational Excellence, Performance Measurement, Pricing Strategies, Relationship Building, Strategic Thinking, Team Management. The Field Reimbursement Manager (FRM) is responsible for serving as the primary field-based lead for education, assistance, and issue resolution with healthcare providers (HCPs) and their office staff, with respect to patient access to J&J Neuroscience therapies.
NewField Reimbursement Manager, Neuroscience - (Hartford, CT) - Patient Engagement & Customer Solutions (PECS) Johnson & JohnsonField Reimbursement Manager, Neuroscience - (Hartford, CT) - Patient Engagement & Customer Solutions (PECS)Titusville, NJRequired Skills: Preferred Skills: Account Management, Analytical Reasoning, Competitive Landscape Analysis, Compliance Management, Cross-Functional Collaboration, Developing Others, Fact-Based Decision Making, Inclusive Leadership, Leadership, Market Access Reimbursement, Market Opportunity Assessment, Operational Excellence, Performance Measurement, Pricing Strategies, Relationship Building, Strategic Thinking, Team Management. The Field Reimbursement Manager (FRM) is responsible for serving as the primary field-based lead for education, assistance, and issue resolution with healthcare providers (HCPs) and their office staff, with respect to patient access to J&J Neuroscience therapies.
NewField Reimbursement Manager, Neuroscience -(Phoenix, AZ ) - Patient Engagement & Customer Solutions (PECS) Johnson & JohnsonField Reimbursement Manager, Neuroscience -(Phoenix, AZ ) - Patient Engagement & Customer Solutions (PECS)Titusville, NJRequired Skills: Preferred Skills: Account Management, Analytical Reasoning, Competitive Landscape Analysis, Compliance Management, Cross-Functional Collaboration, Developing Others, Fact-Based Decision Making, Inclusive Leadership, Leadership, Market Access Reimbursement, Market Opportunity Assessment, Operational Excellence, Performance Measurement, Pricing Strategies, Relationship Building, Strategic Thinking, Team Management. The Field Reimbursement Manager (FRM) is responsible for serving as the primary field-based lead for education, assistance, and issue resolution with healthcare providers (HCPs) and their office staff, with respect to patient access to J&J Neuroscience therapies.