Sr. Call Center Service Assoc Blue Cross and Blue Shield AssociationSr. Call Center Service AssocHopewell, NJ$52,787–$70,172 / yearThis compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. Responsibilities: Receive escalated customer inquiries and provide second level resolution by initiating or continuing investigation process, utilizing available resources and accurately documenting customer inquiry and actions taken in accordance with departmental quality guidelines.
Billing Representative Penn MedicineBilling RepresentativeDoylestown, PA4. Enter insurance data, prepare and submit claims to all insurance companies and patients, receive remittance lists from insurance companies, identify payments and denials, apply payments to patient records for all sources, and investigate and follow up on denied claims. Develop an understanding of Medicare, Medicaid, intermediary and 3rd party pay rules and regulations as applied to Provider services to facilitate account resolution Receives, identifies and applies payments from all sources to patient accounts.
Senior Analyst, Payment Integrity Disputes Oscar HealthSenior Analyst, Payment Integrity DisputesPhiladelphia, PARemote$64,832–$85,092 / yearYou will leverage a deep understanding of Oscar's claim infrastructure, workflows, workflow tooling, platform logic, data models, etc., to work cross-functionally and understand and translate friction from stakeholders into actionable opportunities for improvement. Work Location: This is a remote position, open to candidates who reside in: Atlanta, Georgia; Chicago, Illinois; Dallas, Texas; Louisville, Kentucky; Minneapolis, Minnesota; Philadelphia, Pennsylvania; Salt Lake City, Utah.
Value & Implementation (V&I) Medical Data Analytics Center Data Enablement Associate Director Merck & Co IncValue & Implementation (V&I) Medical Data Analytics Center Data Enablement Associate DirectorNorth Wales, PA$156,900–$247,000 / yearRequired Skills: Active Listening, Actuarial Science, Big Data, Business Acumen, Business Intelligence (BI), Database Design, Data Engineering, Data Modeling, Data Science, Data Visualization, Detail-Oriented, Health Data Analytics, Medical Insurance Coding, Object-Oriented Design (OOD), Object Oriented Modeling, Object-Oriented Programming (OOP), Software Development, Stakeholder Relationship Management, Trend Knowledge, Version Control. Bachelor's degree (computer science, physics, mathematics, actuarial science, or equivalent) with 10 years of relevant job experience; Master's degree (computer science, physics, mathematics, actuarial science, or equivalent) with 8 years of relevant job experience; PhD (computer science, physics, mathematics, actuarial science, or equivalent) with 5 years of relevant job experience.
Associate Optometrist - LensCrafters - Plymouth Meeting, PA EssilorLuxottica SAAssociate Optometrist - LensCrafters - Plymouth Meeting, PAPlymouth Meeting, PAIf you would like to provide feedback regarding an active job posting, or if you are an individual with a disability who would like to request a reasonable accommodation, please call the EssilorLuxottica SpeakUp Hotline at 844-303-0229 (be sure to provide your name, job id number, and contact information so that we may follow up in a timely manner) or email EmployeeRelations@luxotticaretail.com. LensCrafters is part of EssilorLuxottica, a global leader in the design, manufacture and distribution of world-class vision care products, including iconic eyewear, advanced lens technology and cutting-edge digital solutions.
Orthotist Enovis CorpOrthotistCamden, NJIncludes American Board for Certification (ABC) Certified Orthotist (CO), Certified Prosthetist Orthotist (CPO), Board of Certification (BOC) Certified Orthotist (BOCO), National Board Certification for Occupational Therapy (NBCOT) Registered Occupational Therapist (OTR), or Federation of State Boards of Physical Therapy (FSBPT) Licensed Physical Therapist. This is an incredible opportunity to work in a fast-moving, patient-focused setting amongst extraordinarily talented professionals dedicated to making life-changing innovation possible in orthopedics and beyond with brands such as DonJoy, Aircast, ProCare and Exos.
SIU Investigator Centene Corporation GroupSIU InvestigatorPA$56,200–$101,000 / yearCollaborates with internal business partners, compliance, legal, provider and payment integrity teams, and external agencies to coordinate investigative activities, support corrective actions, recoveries, and case resolution efforts. 2+ years Fraud, waste, and abuse investigations, healthcare investigations, claims audits, payment integrity, healthcare compliance, law enforcement investigations, or a related investigative field required.
Vice President, Market Access & Strategy, Commercial Cabaletta Bio IncVice President, Market Access & Strategy, CommercialPhiladelphia, PAPipeline & Business Development Support Partner with New Product Planning (NPP) on future indications and business development opportunities. Market Research & Insights Oversee payer and hospital market research to inform pricing, access strategy, and evidence needs.
Insurance Specialist Cooper University HospitalInsurance SpecialistCAMDEN, New JerseyFull timeOur extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols. Short Description: An Insurance Specialist will be conducting interviews with patients and families to ensure insurance coverage, which includes obtaining benefit information and pre-certification.
Financial Screening Navigator Cooper University HospitalFinancial Screening NavigatorCamden, New JerseyFull timeShort Description: Financially screens uninsured and underinsured patients prior to inpatient and outpatient services, including office visits, testing, diagnostic studies, surgeries and procedures. Assesses patient financial status and explores all third party liability options (e.g., Charity Care, Disability, Medicaid, SEED Program, Victims of Crime, grants) to assist patients.
Senior Director Operations Penn MedicineSenior Director OperationsPhiladelphia, PAProvides strategic and operational oversight of CPUP ambulatory psychiatry practices, ensuring consistency in practice management operations across all locations, including patient access, provider scheduling and template optimization, clinical capacity management, space utilization, referral workflows, workforce planning, telepsychiatry utilization, strategic growth initiatives, and practice performance improvement. The Senior Director of Operations (SDOO) serves as a trusted advisor to the Department Chair, COO & VCCO and plans, leads, directs, and evaluates all day-to-day operations of the Department of Psychiatry's clinical services, both internal to the department and integrated with other departments and entities, to ensure strategic, operational, and financial success.
Insurance Specialist Cooper University Health CareInsurance SpecialistCAMDEN, NJOur extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols. An Insurance Specialist will be conducting interviews with patients and families to ensure insurance coverage, which includes obtaining benefit information and pre-certification.
Financial Screening Navigator Cooper University Health CareFinancial Screening NavigatorCamden, NJFinancially screens uninsured and underinsured patients prior to inpatient and outpatient services, including office visits, testing, diagnostic studies, surgeries and procedures. Assesses patient financial status and explores all third party liability options (e.g., Charity Care, Disability, Medicaid, SEED Program, Victims of Crime, grants) to assist patients.
Part Time Physician Assistant (PA-C) in Dermatology Private Practice Philadelphia Center for DermatologyPart Time Physician Assistant (PA-C) in Dermatology Private PracticeJenkintown, PAPart timeWe are an established, physician‑owned dermatology clinic seeking a part‑time Physician Assistant who is clinically strong, personable, and eager to grow with our team. Order and interpret laboratory tests, imaging, and pathology reports ; communicate results promptly to patients.
Revenue Cycle Specialist Wills Eye HospitalRevenue Cycle SpecialistPhiladelphia, PennsylvaniaThe Revenue Cycle Specialist is responsible for providing top-notch billing services while ensuring accuracy and efficiency in managing inpatient claims. Accurately bills inpatient medical claims within established timelines and initiates dialog with payors, patients and departments.
Community Pharmacy Team Lead (Thursday to Monday, 10:00AM - 6:30PM ET) AnewHealthCommunity Pharmacy Team Lead (Thursday to Monday, 10:00AM - 6:30PM ET)New JerseyRemoteAbility to communicate effectively and professionally through written, verbal (e.g., face-to-face, telephonically and/or virtual communication platforms), and interpersonal skills as applied when interacting with employees, patients, healthcare professionals, clients, or agency representatives; successfully conveying and exchanging information at an appropriate level and in a positive and timely manner. Established in 2023 through the combination of ExactCare and Tabula Rasa HealthCare, we provide a suite of solutions that includes comprehensive pharmacy services; full-service pharmacy benefit management; and specialized support services for Program of All-Inclusive Care for the Elderly.
Clinical Quality Coder II Sutter HealthClinical Quality Coder IINJ$35.04–$52.56 / hourSKILLS AND KNOWLEDGE: Advanced knowledge of ICD-10 diagnosis coding conventions and requirements, knowledge of Quality Coding Program requirements such as the Medicare Advantage Coding Program/HCC, as well as medical terminology and abbreviations of disease, illness and injury process. Position Overview: This position conducts review of outpatient medical records using International Classification of Disease Coding ICD-10-CM and Current Procedural Terminology (CPT), Medicare Advantage, ICD-10-CM, and Centers for Medicare and Medicaid Services (CMS) coding and reporting guidelines.
Remote Certified Professional Coder/ PIP Adjuster EDI StaffingRemote Certified Professional Coder/ PIP AdjusterHamilton, NJRemoteInterpret medical documentation ensure accuracy of billed services IE: CPT, HCPCs codes. Qualifications and Experience: 3-5 years experience conducting code reviews; specifically NJ / NY PIP fee schedules.
HIM Coder - Remote/Mt. Holly (FT) CCS Required Virtua Health IncHIM Coder - Remote/Mt. Holly (FT) CCS RequiredMt. Holly, NJRemote$26.22–$40.65 / hourPosition Responsibilities: Accurately reviews each record and knowledgeably utilizes ICD-10-CM, ICD-10-PCS, CPT-4, and encoder to accurately code all significant diagnoses and procedures according to American Hospital Association (AHA), American Health Information Management Association (AHIMA), Uniform Hospital Discharge Data Set (UHDDS) hospital specific guidelines and rules/conventions. Remote Type: On-Site Employment Type: Employee Employment Classification: Regular Time Type: Full time Work Shift: 1st Shift (United States of America) Total Weekly Hours: 40 Additional Locations: Job Information: Please note all candidates must complete & pass onsite testing in Marlton, NJ prior to an interview.
NewDRG Appeals Nurse (RN) CorroHealth IncDRG Appeals Nurse (RN)NJRemoteValidates that all ICD-10-CM/PCS, discharge disposition codes, and Hospital Acquired Condition (HAC), Present on Admission (POA) indicators impacting payment are documented, clinically supported, and assigned following Official Coding Guidelines, compliant query practices and current clinical validation criteria. Possess regulatory ICD-10-CM/PCS coding expertise coupled with subject matter expertise in MS/APR DRG payment methodologies, including Hospital Acquired Conditions (HACs), POA assignment, and Discharge Disposition codes.