NewSenior Analyst, Payment Integrity Oscar Health IncSenior Analyst, Payment IntegrityNew York, NYRemote$64,832–$85,092 / yearThis is accomplished by leveraging a deep understanding of Oscar's claim infrastructure, workflows, workflow tooling, platform logic, data models, etc., to work cross-functionally to 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.
Director of Patient Access Services-Patient Financial Services-Corporate 42nd Street-Full-Time Days Mount Sinai Health SystemDirector of Patient Access Services-Patient Financial Services-Corporate 42nd Street-Full-Time DaysNew York, NY$127,044–$190,565 / yearCollaborating with hospital and physician leadership, this position works closely with Revenue Integrity, Coding, Billing, Cash Posting, and Case Management in defining vision, strategy and priority setting for system wide-revenue operations system initiatives, including: The integration and distribution of information that contributes to the capture, management, and collection of hospital patient service revenue using a holistic perspective to ensure that the business processes are operating in an integrated, efficient state to achieve maximum effectiveness; Improving business processes to maximize and protect the assets of the enterprise by enhancing and maintaining a properly functioning revenue cycle process through a cross-department organizational structure; Establishing and maintaining key revenue cycle performance indicators for the enterprise in support of BMC's strategic plan. 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.
Data Manager Maimonides Medical CenterData ManagerBrooklyn, New York$70,000–$85,000 / yearFull timeThe system is anchored by Maimonides Medical Center, one of the nation’s largest independent teaching hospitals and home to centers of excellence in numerous specialties; Maimonides Midwood Community Hospital (formerly New York Community Hospital), a 130-bed adult medical-surgical hospital; and Maimonides Children's Hospital, Brooklyn's only children's hospital and only pediatric trauma center. Prepares actionable analyses and reports to support managed care and value-based contracting, including trend analyses (volume, spend, unit cost, case mix, LOS), cost and utilization analyses, and benchmark comparisons; prepare reports using SQL server, Microsoft Access; assists in proposal development and contract renewals.
Orthotist EnovisOrthotistUSA, 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.
Product Security Engineer Candid HealthProduct Security EngineerNew York, NY$180,000–$258,000 / yearMedical billing is expensive because it's nuanced and hard - maybe ~100x harder than credit card payment processing - and because it's traditionally done by armies of humans who track and manage complex rules and processes specific to individual insurance companies with little or no supporting software. We're rethinking medical billing from the ground up, building software backed by best-in-class data science (and, soon, a dash of machine learning) to automate much of this complexity so healthcare providers can get paid dramatically more easily and inexpensively.
Associate Product Manager- Denials AI Med-Metrix, LLCAssociate Product Manager- Denials AIParsippany-Troy Hills, NJPhysical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear. Orient new hires and provide in-services and training, continuing education, and development related to those functional areas of responsibility.
Clinical Documentation Integrity Specialist - Remote Med-Metrix, LLCClinical Documentation Integrity Specialist - RemoteParsippany-Troy Hills, NJRemoteThe Clinical Documentation Integrity Specialist performs concurrent chart reviews to validate that the clinical documentation in the medical record appropriately describes the patient's severity of illness, complexity of care, and risk of mortality to facilitate appropriate coding. Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
Field Ancillary Support Specialist Tristate HRHField Ancillary Support SpecialistJersey City, New JerseyIn this role, you will provide high-quality patient-facing specimen collection and ensure compliant, timely, and accurate specimen processing in a fast-paced healthcare environment. This role is ideal for a candidate who is flexible, highly reliable, and comfortable working across multiple locations, multiple shifts, and multiple EMR systems.
Facility-Fee Emergency Department Medical Coder Sutherland GlobalFacility-Fee Emergency Department Medical CoderClifton, NJThe Facility-Fee Emergency Department Medical Coder is responsible for the accurate review, abstraction, and assignment of ICD-10-CM, CPT, HCPCS, facility-specific charging methodologies, and applicable modifiers for Emergency Department (ED) facility encounters. The coder will review clinical documentation, emergency department records, physician documentation, nursing notes, ancillary reports, and charging information to accurately capture facility services rendered during emergency department visits.
Quality Analyst - Clinical Validation Audit ExlService Holdings IncQuality Analyst - Clinical Validation AuditNYRemote$85,000–$100,000 / yearResponsible for reviewing the accuracy and consistency of clinical DRG auditing auditors to ensure audits are appropriately marked for findings and no findings. For positions based in higher-cost zones (e.g., California, New York, New Jersey), actual compensation may exceed the posted range; your recruiter will share specifics during the process.
Clinical Documentation Integrity Specialist Episcopal Health ServicesClinical Documentation Integrity SpecialistFar Rockaway, New YorkAdditionally, St. John's 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.
Medical Records Coder II, Full Time, Family Medicine, Summit Atlantic Health System IncMedical Records Coder II, Full Time, Family Medicine, SummitSummit, 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.
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.
Senior Consultant, Revenue Cycle And Financial Operations | Healthcare Business Transformation FTI Consulting, Inc.Senior Consultant, Revenue Cycle And Financial Operations | Healthcare Business TransformationNew York, NYThe Senior Consultant in Revenue Cycle and Financial Operations within our Healthcare Business Transformation practice plays a key leadership role advising physician groups, health systems, private equity and technology companies on strategies to optimize financial performance and operating effectiveness across the revenue cycle. This role supports complex client engagements from assessment through implementation, partners directly with client executives to align initiatives to enterprise priorities, and delivers measurable outcomes related to cost optimization, revenue enhancement, technology implementation and financial operations.
Senior Consultant, Revenue Cycle and Financial Operations | Healthcare Business Transformation FTI Consulting IncSenior Consultant, Revenue Cycle and Financial Operations | Healthcare Business TransformationNew York, NYThe Senior Consultant in Revenue Cycle and Financial Operations within our Healthcare Business Transformation practice plays a key leadership role advising physician groups, health systems, private equity and technology companies on strategies to optimize financial performance and operating effectiveness across the revenue cycle. This role supports complex client engagements from assessment through implementation, partners directly with client executives to align initiatives to enterprise priorities, and delivers measurable outcomes related to cost optimization, revenue enhancement, technology implementation and financial operations.
Diagnosis-Related Group (DRG) Auditor III ExlService Holdings IncDiagnosis-Related Group (DRG) Auditor IIINYRemote$73,000–$98,700 / yearEXL never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process and has not authorized any agencies or partners to collect any fee or payment from prospective candidates. EXL harnesses the power of data, analytics, AI, and deep industry knowledge to transform operations for the world's leading corporations in industries including insurance, healthcare, banking and financial services, media and retail, among others.
NewDRG Quality Manager ExlService Holdings IncDRG Quality ManagerNYRemote$100,000–$120,000 / yearThe role directly manages a team of DRG quality analysts responsible for reviewing auditor-completed MS-DRG and APR-DRG work, validating audit accuracy, and ensuring accurate coding and reimbursement outcomes. High-quality, accurate, timely, and consistent quality review results across DRG and assigned programs, including correct DRG validation, clinical support, coding guideline application, and audit rationale quality.
NewManager, Data Mining - Payment Integrity Oscar Health IncManager, 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.
Configuration and Quality Audit Analyst | Hybrid NY HealthfirstConfiguration and Quality Audit Analyst | Hybrid NYNew York, NY$68,900–$99,620 / yearAt least three years of experience in a managed care organization, commercial health plan, government program, third-party administrator, or other healthcare operations environment performing claims analysis, configuration audit, provider reimbursement, payment integrity, or healthcare data analysis. Candidate must display effective communication skills and have detailed skillset to configure Office365, effectively communicate product updates, interface with the vendor on potential issues, and ensure platform governance rules are followed.
NewBilling 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.