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.
Service Account Specialist - Billing Quest Diagnostics IncService Account Specialist - BillingClifton, NJAccount visits will be prioritized based on evaluation of trends that show education needs in: Medicare Limited Coverage Policy/ABNMedicaid requirements/policiesRegional specific third-party requirements/policiesOrdering provider registration (PECOS)Missing demographic/insurance information for ordering physician and patientSupport Commercial Sales team with client training and education as required for large new customers and/or new billing initiatives. Responsibilities: Improve billing data quality through the education and account management of customers, with efforts and emphasis to reduce missing information, bad debt, non-supported diagnosis/non-covered test write-offs, self-pay write-offs, and third-party denials.
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.
Medical Assistant - Urology UnitedHealth Group IncMedical Assistant - UrologyLake Success, NYClinical › Corporate and business operations › Customer and support services › Early careers› Sales and account management › Technology and data› Physicians› Advanced practice clinicians› Pharmacy› Behavioral health› Nursing› Medical coding› Clinical support› U.S. › Ireland & UK › India › Philippines › Culture of Belonging› Employee Benefits› Blog. Technology and data Artificial intelligence Architecture Business systems analysis Data analytics Data engineering Data science Network infrastructure Product management & development Security and risk Software engineering.
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).
Medical Office Manager The Cardiovascular Care GroupMedical Office ManagerClifton, NJOversee revenue cycle activities, including coding accuracy, charge capture, prior authorizations, claim submissions, denials management, collections, and collaboration with billing teams. Manage clinical and patient support functions, including prescription refills, patient clinical inquiries, disability forms, CT/MRI authorizations, and weekly chart preparation.
Billing Manager DocGo IncBilling ManagerNY$75,000–$85,000 / yearDocGo's proprietary, AI-powered technology, logistics network, and dedicated field staff of over 5,000 certified health professionals elevate the quality of patient care and drive efficiencies for municipalities, hospital networks, and health insurance providers. About DocGo: DocGo is leading the proactive healthcare revolution with an innovative care delivery platform that includes mobile health services, population health, remote patient monitoring, and ambulance services.
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.
Director, Payment Integrity Capital Rx, Inc.Director, Payment IntegrityNew York, NY$206,400–$258,000 / yearPosition Summary: The Director, Payment Integrity will build and lead Judi Health's payment integrity program from inception, establishing the infrastructure, processes, and team that will ensure claims are paid correctly, compliantly, and efficiently across our commercial plan population. By delivering true price transparency, eliminating unnecessary middleman fees, and leveraging advanced AI-powered care delivery, Judi Health helps clients achieve unprecedented operational efficiency and service levels.
RCM Customer Service Specialist The Dermatology SpecialistsRCM Customer Service SpecialistLong IslandThe role handles inquiries via phone, email, and EMR-tasked billing requests, assists patients with billing questions, and ensures accurate interpretation of Explanation of Benefits (EOBs), payment postings, and claim denials. The CSR collaborates with the Revenue Cycle team and Ops team to support timely resolution, maintain high patient satisfaction, and improve financial outcomes for the dermatology practice.
Medical Biller Integrity Placement GroupMedical BillerBayonne, NJ$20–$25 / hourThe ideal candidate will be responsible for accurately processing medical claims, managing insurance billing, and ensuring timely reimbursement while maintaining compliance with healthcare regulations. The practice is committed to providing exceptional patient care while helping patients achieve long-term health and wellness.
DRG Reviewer MedReviewDRG ReviewerNew York, NYRemote$85,000–$90,000 / yearUnder the direction of the DRG Operations leadership team, the DRG Reviewer conducts reviews of inpatient claims to ensure coding accuracy and appropriate DRG assignment while identifying cases requiring clinical review to support coded diagnoses. Responsibilities: Analyze and review inpatient claims following the Official Coding and Reporting Guidelines to validate the reported ICD-10-CM/PCS codes to ensure proper DRG assignment for accurate billing.
Billing Supervisor DocGoBilling SupervisorRidgewood, New YorkDocGo's proprietary, AI-powered technology, logistics network, and dedicated field staff of over 5,000 certified health professionals elevate the quality of patient care and drive efficiencies for municipalities, hospital networks, and health insurance providers. DocGo is leading the proactive healthcare revolution with an innovative care delivery platform that includes mobile health services, population health, remote patient monitoring, and ambulance services.
Billing Manager DocGoBilling ManagerRidgewood, New YorkDocGo's proprietary, AI-powered technology, logistics network, and dedicated field staff of over 5,000 certified health professionals elevate the quality of patient care and drive efficiencies for municipalities, hospital networks, and health insurance providers. DocGo is leading the proactive healthcare revolution with an innovative care delivery platform that includes mobile health services, population health, remote patient monitoring, and ambulance services.
IMG for chart review CROSS COUNTY MEDICAL CAREIMG for chart reviewElmont, NYPart timeCross County Medical Care is a trusted healthcare provider serving the Bellerose, NY community with a commitment to high-quality, patient-centered care. This is a fantastic opportunity for a medically trained professional to contribute their clinical knowledge in a detail-oriented, documentation-focused role.
Insurance Authorization Specialist - NYC Human HireInsurance Authorization Specialist - NYCNew York, NYHumanHire is a national executive search and staffing firm with a leadership team that has over 50 years of experience as trusted industry professionals specializing in direct hire, temp to hire, temporary and payrolling services. If this is not the ideal position for you but are still interested in hearing about what other job opportunities are in your area, please visit www.humanhirellc.com and email your resume to jobs[at]humanhirellc.com!
NewMedical Office Associate I, Per Diem, Days, 8am-4pm, AMG Head Neck Surgery, Morristown, NJ Atlantic Health System IncMedical Office Associate I, Per Diem, Days, 8am-4pm, AMG Head Neck Surgery, Morristown, NJMorristown, 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.
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.