CPC Investigator Blue Cross and Blue Shield AssociationCPC InvestigatorNewark, NJ$70,500–$94,395 / yearThe Certified Professional Coder (CPC) is responsible for performing reviews, audits and coding oversight of medical records to ensure the appropriate CPT codes, diagnosis codes and modifiers according to Generally Accepted Medical Coding Guidelines, CPT-4; HCPCS; ICD-10 Guidelines; and, CMS Correct Coding. The incumbent will also be responsible for handling low level investigative activities (external) related to claims, enrollment, accounting, receive and review suspected fraud and to complete cases with all information and analysis for resolution, as the manager and prior approved guidelines may direct.
Charge Entry and Eligibility Specialist The Cardiovascular Care GroupCharge Entry and Eligibility SpecialistClifton, NJThe Charge Entry and Eligibility Specialist supports The Cardiovascular Care Group's commitment to delivering exceptional vascular care by ensuring accurate billing, efficient revenue cycle operations, and a positive patient financial experience. The ideal candidate demonstrates strong attention to detail, knowledge of medical billing processes, excellent customer service skills, and the ability to work effectively in a fast-paced healthcare environment.
Medical Biller Javier Zelaya MD PCMedical BillerBrooklyn, New York$18–$22 / hourThe team provides medical dermatology treatment options and full body screenings for a number of skin conditions including melanoma and other skin cancers, acne, rosacea, eczema, psoriasis, cysts, skin rashes and allergies, hyperpigmentation, aging skin, photodamage, vitiligo, warts, sweat, hair loss and more. Board certified Dermatologist and Internist, Dr. Javier Zelaya, with over 25 years of dermatology, cosmetic, laser and surgical experience works alongside a skilled team Physician Assistants, Nurse Practitioners and licensed Medical Esthetician.
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.
NewCPC Investigator Horizon Healthcare ServicesCPC InvestigatorNewark, New JerseyThe Certified Professional Coder (CPC) is responsible for performing reviews, audits and coding oversight of medical records to ensure the appropriate CPT codes, diagnosis codes and modifiers according to Generally Accepted Medical Coding Guidelines, CPT-4; HCPCS; ICD-10 Guidelines; and, CMS Correct Coding. $70,500 - $94,395 This 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.
NewCharge 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.
Supervisor, Education/Audit, Physician Billing Hackensack Meridian HealthSupervisor, Education/Audit, Physician BillingEdison, New JerseyRemoteFull timeUnder the general direction of the Physician Billing (PB) Director of Coding and Manager of Education and Audit, the Supervisor, Education/Audit, Physician Billing will supervise the Coding Education and Audit team and conducts audits for medical provider documentation while adhering to Centers for Medicare and Medicaid Services (CMS) and Office of Inspector General (OIG) guidelines for Hackensack Meridian Health (HMH). The posted rate of pay in this job posting is a reasonable good faith estimate of the minimum base pay for this role at the time of posting in accordance with the New Jersey Pay Transparency Act and does not reflect the full value of our market-competitive total rewards package.
Professional Coder I eTeam Inc.Professional Coder INewark, NJRemote$35–$42.38 / hourThis position supports Annual Commercial (ACA) and Medicare Advantage Risk Adjustment Data Validation Audits (RADV) along with the annual Risk Adjustment life cycle for the Medicare, Medicaid, and Commercial lines of business. Qualifications: Requires current Registered Health Information Technologies (RHIT) or Certified Professional Coder designation from the American Academy of Professional Coders or a Certified Coding Specialist, P from the American Health Information Management (AHIMA).
Charge Master Analyst Sutter HealthCharge Master AnalystTrenton, NJ$106,745.60–$160,118.40 / yearPosition Overview: Serves as a subject matter expert for Charge Description Master (CDM) regulatory requirements and guidelines and payer contractual obligations in order to ensure CDM line items are aligned with current billing, coding regulations, guidelines, and contractual obligations. Maintains the CDM data elements (billing description, Current Procedural Terminology/Healthcare Procedure Coding System codes, revenue codes for Inpatient/Outpatient and appropriate modifiers) in the CDM software.
NewField Reimbursement Manager, Greensboro NC - Dermatology 6077-Johnson & Johnson HCS Legal EntityField Reimbursement Manager, Greensboro NC - DermatologyTitusville, New JerseyAccount 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.
Denials Coordinator - Hospital Billing Patient Financial Services - Corporate 42nd Street - Full-Time - Days Mount Sinai Health SystemDenials Coordinator - Hospital Billing Patient Financial Services - Corporate 42nd Street - Full-Time - DaysNew York, NY$65,885–$98,827 / yearKey responsibilities include analyzing claim denial reasons, identifying denial trends, sharing trends and findings with owner areas, coordinating the appeals process, collaborating with departments to prevent future denials, maintaining documentation including issue logs with updates, denied dollars and resolutions, and acting as a resource for staff regarding denial-related issues and payer rules. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time - discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it.
Medical Records Associate The Cardiovascular Care GroupMedical Records AssociateNJConsistently recognized by their peers and patients as the top group in the region, The Cardiovascular Care Group provides the highest quality care using the newest technologies in the setting of years of experience with outstanding results. Effective communication skills facilitate collaboration with healthcare providers and administrative personnel to resolve documentation issues and support quality patient care.
Revenue Cycle Specialist Henry J. Austin Health Center IncRevenue Cycle SpecialistTrenton, NJ$48,500–$85,400 / yearProvider billing experience, preferably in an FQHC or similar setting (3-5 years) with an understanding of medical insurances ie; Medicare, Medicaid, Managed Care, and Commercial insurances, and a thorough understanding of medical insurance billing basics, ie; charges, allowed amounts, payments, adjustments, denials, capitation, eligibility, coordination of benefits. Responsibilities include organizing and prioritizing workflows, setting deadlines for finance department staff and external billing vendors, and providing analytical support to other departments on revenue cycle matters.
Revenue Cycle Billing Specialist - FT - Day - MSO/Centralized Billing Lawrenceville NJ Capital HealthRevenue Cycle Billing Specialist - FT - Day - MSO/Centralized Billing Lawrenceville NJNJ$19.32–$24.13 / hourResponsible for all aspects of claim submission for services rendered at Capital Health through the Revenue Cycle life cycle to all payers, including but not limited to pre and post claim review, claim (277) rejections, denial review, and claim resubmission. Reviews hospital billing reports for corrections needed in order to have the accounts final bill - these includes but are not limited to: Late Charge report, 72-hour report, etc. to ensure claims are billed timely and accurately (hospital only).
Denials Representative -Full-Time Holy Name Medical CenterDenials Representative -Full-TimeHackensack, NJ$22–$25.30 / hourFull timeHoly Name is New Jersey's only independent Catholic health system, comprising a 361-bed acute care hospital, a renowned cancer center, a state-of-the-art fitness center, a residential hospice, a prestigious nursing school, and an extensive physician network. This position collaborates with internal departments and insurance payers to resolve claim issues, identify denial trends, and support process improvements that strengthen the hospital's revenue cycle.
Revenue Cycle Specialist Henry J Austin Health CenterRevenue Cycle SpecialistTrenton, NJ$48,500–$85,400 / yearProvider billing experience, preferably in an FQHC or similar setting (3-5 years) with an understanding of medical insurances ie; Medicare, Medicaid, Managed Care, and Commercial insurances, and a thorough understanding of medical insurance billing basics, ie; charges, allowed amounts, payments, adjustments, denials, capitation, eligibility, coordination of benefits. Responsibilities include organizing and prioritizing workflows, setting deadlines for finance department staff and external billing vendors, and providing analytical support to other departments on revenue cycle matters.
Sr. Revenue Cycle Billing Specialist Firstsource Solutions LtdSr. Revenue Cycle Billing SpecialistNY$30–$40 / hourThis role identifies root causes of denials, executes appeals and corrective actions, and collaborates with internal teams to prevent future denials. Work claims across all top denial categories including, but not limited to: No Authorization, Timely Filing, Coordination of Benefits (COB), Medical Necessity, Additional Documentation Requests (ADR), Bundling (NCCI edits), and Duplicate Claims.
NewMedical Office Associate II, Per Diem, Days, AMG Family Medicine, Warren, NJ Atlantic Health System IncMedical Office Associate II, Per Diem, Days, AMG Family Medicine, Warren, NJNJWe are a multispecialty physician group with more than 1,000 doctors, nurse practitioners and physician assistants at over 300 locations throughout northern and central New Jersey and northeast Pennsylvania. Atlantic Medical Group is a physician-led and physician-governed organization that delivers the highest quality health care, at the right place, the right price, and the right time.
NewMedical Office Associate I, Per Diem, Varied Shifts, AMG-Cardiology & Medical Specialties, Multiple Locations. Atlantic Health System IncMedical Office Associate I, Per Diem, Varied Shifts, AMG-Cardiology & Medical Specialties, Multiple Locations.Livingston, NJAtlantic Medical Group is a physician-led and physician-governed organization that delivers the highest quality health care, at the right place, the right price, and the right time. We are a multispecialty physician group with more than 1,000 doctors, nurse practitioners and physician assistants at over 300 locations throughout northern and central New Jersey and northeast Pennsylvania.
Inpatient Medical Coder FT - Up to $5k Sign-on Bonus Datavant LLCInpatient Medical Coder FT - Up to $5k Sign-on BonusNYRemote$32–$42 / hourGuided 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. What Helps You Stand Out: Associate or Bachelor''s degree from an AHIMA-certified HIM or Nursing Program, or completion of a certificate program from AHIMA/AAPC with a preference for CCS.