ProFee Audit Specialist- PRN Datavant LLCProFee Audit Specialist- PRNNYRemote$35–$45 / hourWhat We're Looking For: As a Profee Auditing Specialist, you will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, interim coding management, and coding workflow operations reviews. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies.
Outpatient Audit Specialist PRN - Remote Datavant LLCOutpatient Audit Specialist PRN - RemoteNYRemote$35–$45 / hourWhat We're Looking For: As an Outpatient Auditing Specialist, you will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, and coding workflow operations reviews. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies.
ProFee Audit Specialist- PRN DatavantProFee Audit Specialist- PRNNew York, NYRemote$35–$45 / hourAs a Profee Auditing Specialist, you will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, interim coding management, and coding workflow operations reviews. The estimated base pay range per hour for this role is: $35—$45 USD To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc.
Risk Adjustment Expert - Fully Remote MercorRisk Adjustment Expert - Fully RemoteNew York, New YorkRemote5+ years of experience in risk adjustment coding , HCC coding , or Medicare Advantage coding operations , with at least 2 years in a leadership role. Lead risk adjustment and HCC coding operations across Medicare Advantage , Medicaid , and ACA risk adjustment programs.
CDI Specialist Episcopal Health Services IncCDI SpecialistNYAdditionally, St. Johns is proud to be redesignated as a Baby-Friendly Hospital by Baby-Friendly USA - the accrediting body and national authority for the Baby-Friendly Hospital Initiative (BFHI) in the United States. The hospital is a recipient of the Gold-Plus Get with the Guidelines-Stroke Quality Achievement Award and the Gold-Plus Get with the Guidelines-Heart Failure Quality Achievement Award from the American Heart Association.
DRG Clinical Validation Nurse MedReviewDRG Clinical Validation NurseManhattan, NY$85,000–$95,000 / yearSolid understanding of anatomy and physiology, diagnostic and surgical procedures developed from specialized training and extensive experience with ICD-10-PCS code assignments. Here is what we are searching for: Responsibilities: Perform clinical validation by ensuring diagnosis codes billed by the provider are supported within the medical record.
Lead CDI Specialist Second Level Reviewer Garnet HealthLead CDI Specialist Second Level ReviewerMiddletown, New YorkRemote$48.85–$57.90 / hourFull timeIf you’re interested in a health system that’s both growing and award-winning, serving a diverse community that provides the best of both city and rural life, we invite to make your career home with us as a Lead Clinical Documentation Specialist 2nd Level Reviewer on our Clinical Documentation Intergrity team at/in Garnet Health Medical Center-Middletown. When determining a team member’s compensation and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity) .
Medical Biller Specialist I Urban Health Plan IncMedical Biller Specialist IBronx, NYRemoteAbout Urban Health Plan: At Urban Health Plan (UHP) our mission is to continuously improve the health of communities and the quality of life of the people we serve by providing affordable, comprehensive, quality, primary and specialty health care and by assuring the performance and advancement of innovative best practices. The Billing Specialist will review medical documentation to property bill services and treatment provided and submit claims to the payers following ICD-10, CPT coding and insurance guidelines.
Executive Medical Director, Neurology, Clinical Development Karwell TechnologiesExecutive Medical Director, Neurology, Clinical DevelopmentBridgewater, NJThis individual will be the primary point person for medical monitoring and oversight of assigned clinical programs, including monitoring of clinical studies, review and interpretation of clinical trial data, authoring clinical study and regulatory communications and documents, and monitoring of competitor activities and data. Provide medical/clinical expertise to internal (Marketing, Sales, Manufacturing, Market Access, Patient Services, Regulatory Affairs, R&D, and Legal) and external (healthcare professionals, Data Safety Monitoring Boards, patients, advocacy groups, etc.) customers.
Med Records Coder III University of RochesterMed Records Coder IIINew York, NY$21.78–$30.53 / hourAmerican Health Information Management Association (AHIMA) accreditation examination for Registered Health Information Administrator (RHIA) or (Registered Health Information Technician) RHIT or Certified Coding Specialist (CCS) preferred. Uses knowledge of coding systems and system logic to review codes created by electronic charge capture and/or assigns codes through medical record documentation as per designated workflow.
DRG Reviewer MachinifyDRG ReviewerNY$90,000–$115,000 / yearAs part of the Complex Payment Solutions Team, you will, as a DRG Reviewer, be a key contributor responsible for conducting thorough DRG payment validation reviews, including clinical and coding assessments, of medical records and related documentation in accordance with contract-specific review criteria. Qualifications: Inpatient claims auditing, quality assurance or recovery auditing experience of 2 years or more required, and/or Inpatient Clinical Documentation Integrity experience of 2 years or more required.
Clinical Research Scientist NovoCure LtdClinical Research ScientistNY$125,000–$185,000 / yearBeyond contributing to protocol development, clinical strategy, and data interpretation, youll build meaningful partnerships with investigators, participate in study-related site activities, and help ensure the successful execution of clinical trials from concept through completion. Working at the intersection of science and operations, youll collaborate with cross-functional teams across Clinical Development, Clinical Operations, Medical Affairs, Data Management, Regulatory Affairs, Safety, and Device Support Specialists.
Manager, Data Mining - Payment Integrity Oscar Health InsuranceManager, Data Mining - Payment IntegrityNew York, NY$111,780–$146,711 / yearAbout the role: The Manager of Data Mining leads a team of individual contributors, ensuring the team is meeting savings and recovery targets in the payment integrity space. Work Location: This position is based in our New York City office, requiring a hybrid work schedule with 3 days of in-office work per week.
Manager, Data Mining - Payment Integrity Oscar HealthManager, Data Mining - Payment IntegrityNew York, New York$111,780–$146,711 / yearThe Manager of Data Mining leads a team of individual contributors, ensuring the team is meeting savings and recovery targets in the payment integrity space. Work Location: This position is based in our New York City office, requiring a hybrid work schedule with 3 days of in-office work per week.
Director, Clinical Data Management PTC TherapeuticsDirector, Clinical Data ManagementWarren, NJ$200,700–$252,600 / yearThe Director, Clinical Data Management provides strategic and operational leadership and oversight of data management activities to ensure the quality, integrity, consistency and inspection readiness of clinical databases for subsequent analysis, reporting and regulatory submissions. Participate in cross functional team meetings, as requested, and communicate with all departments regarding project statuses/issues, provide ongoing feedback on data management workflows to increase efficiency and provide feedback to CRAs.
Associate Director, Clinical Data Management PTC TherapeuticsAssociate Director, Clinical Data ManagementWarren, NJ$163,800–$206,200 / yearParticipate in cross functional team meetings, as requested, and communicate with all departments regarding project statuses/issues, provide ongoing feedback on data management workflows to increase efficiency and provide feedback to CRAs. The Associate Director, Clinical Data Management is responsible for providing leadership and oversight of data management activities to ensure accuracy and consistency of clinical databases for subsequent analysis and reporting.
Clinical Data AMS Sr. Consultant DeloitteClinical Data AMS Sr. ConsultantNew York, NY$120,200–$140,000 / yearThis role owns the health, stability, and compliance posture of a suite of clinical and regulatory R&D platforms - including Axway Secure Transport (ST), eClinical Elluminate, Eclipse (medical coding), and EAST - across the full engagement lifecycle: implementation, configuration, validation, and steady-state managed services. The team operates at the intersection of IT infrastructure, clinical operations, and quality/regulatory compliance, partnering closely with global business and technology stakeholders to support end-to-end clinical trial data lifecycles from data capture and coding through statistical analysis and submission-ready outputs.
Revenue Cycle Executive - AI Strategy MercorRevenue Cycle Executive - AI StrategyNew York, New YorkRemoteProvide executive-level oversight and strategic direction for end-to-end revenue cycle operations, including patient access, coding, billing, denials, and collections. Define and monitor enterprise revenue cycle KPIs , including net collection rate, days in A/R, denial rate, cost-to-collect, and cash collections performance.
RCM Analytics Director - AI Tools MercorRCM Analytics Director - AI ToolsNew York, New YorkRemote5+ years of experience in revenue cycle analytics, RCM reporting , or healthcare financial decision-support, with at least 2 years in a leadership role. Lead revenue cycle analytics, reporting, and decision-support functions to drive data-driven performance improvement across RCM operations .
Billing Specialist TeemaGroupBilling SpecialistWhite Plains, NY$70,000–$80,000This position serves as a key liaison between clinical teams, insurance payers, and patients, ensuring services are authorized, accurately billed, and compliant with regulatory and payer requirements. The Prior Authorization & Billing Specialist plays a critical role in ensuring timely access to mental health services by managing insurance authorizations, billing processes, and reimbursement workflows.