Billing Specialist, Per Diem (Athena Experience Preferred) VNS HealthBilling Specialist, Per Diem (Athena Experience Preferred)New York, NY$31.94–$38.20 / hourWorks with Clinical Director in preparing internal presentations, knowledge libraries, coding guidelines, and summary reports of coding review for department infrastructure, maintains professional communication with provider engagement team by assisting with analysis, trending, and presentation of audit/review findings, outcomes, and issues. Engages with medical practitioners to provide feedback and educational resources on best practices for medical coding and keeps current on new coding and billing guidelines, federal and state initiatives regarding claims and trains other staff in new/changes to regulations.
Director, Compliance Columbia UniversityDirector, ComplianceNew York, NY$150,000–$160,000 / yearThe Director contributes to the success of CUIMC's mission provides strategic direction and operational leadership for a team of compliance professionals, supports provider education and dispute resolution, and partners closely with Revenue Cycle, Clinical Departments, Legal, and Leadership to mitigate risk and promote compliant billing practices across a large academic medical center. Expert knowledge of the General Compliance Program Guidance issued by the HHS OIG and the DOJ's Evaluation of Corporate Compliance Programs, as well as fraud, waste, and abuse laws (Stark Law, Anti-Kickback Statute, False Claims Act).
Revenue Integrity Analyst (FGP) - Manhattan, CBO North Billing (CPC highly preferred) New York University School of MedicineRevenue Integrity Analyst (FGP) - Manhattan, CBO North Billing (CPC highly preferred)New York, NY$70,481.60–$94,605 / yearKnowledge of: Current Procedures Codes (CPT) and International Class of Diseases Codes (ICD9/10) utilized in medical billing; Medical billing software; Healthcare billing including Medicare, Medicaid, or other third-party payers; Terminology utilized in medical billing; English usage, grammar, and spelling; Basic math. Conducts special projects and special studies to facilitate revenue management as required for system conversions, new facilities/acquisitions, new departments, new service lines, changes in regulations, legal reviews, etc.
NewPatient Advocate Specialist Firstsource Solutions LtdPatient Advocate SpecialistNYRemote$17–$19 / hourE. The goal of the Patient Advocate Specialist is to successfully resolve account balances for medical services provided by multiple healthcare facilities to patients by, contacting the patients by telephone and screen them to determine if the patient is eligible for state, county, and federal assistance programs. Follow-up with assigned accounts until every avenue is exhausted in trying to secure benefits for the patients or the patient is approved for a program and billing information is obtained.
Assistant Director (FGP), Revenue Optimization & Analytics - Radiology, Manhattan New York University School of MedicineAssistant Director (FGP), Revenue Optimization & Analytics - Radiology, ManhattanNY$121,792.22–$210,091.64 / yearWork closely with departmental and revenue cycle leadership on initiatives that target revenue optimization for radiology services, including identifying bottlenecks, analyzing root causes, and implementing corrective measures. Regularly meet with Department Chair and his leadership team to present revenue cycle insights, address payor issues, and review opportunities for improvement using practice-specific and departmental data.
Emergency Dept. Business Associate - Per-Diem (25199) Bergen New Bridge Medical CenterEmergency Dept. Business Associate - Per-Diem (25199)Paramus, New JerseyArranges for the efficient and orderly admission of patients presenting to the Emergency Department, ensuring that all required patient information pertinent to registration is obtained and accurately entered into the EMR per EMTALA and HIPAA compliance regulations. Admits, discharges and transfers patients to and from units such as Emergency Room, Skilled Nursing Facility, Psychiatric Services, SDS, etc.
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!
DRG Clinical Validation Lead Elevance Health IncDRG Clinical Validation LeadNew York, NY$89,520–$161,136 / yearPreferred Skills, Capabilities and Experiences: One or more of the following certifications are preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC. How you will make an impact: Conducts pre-certification, retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.
Paralegal Gottlieb and GreenspanParalegalFair Lawn, NJ$50,000–$60,000 / yearWe are Gottlieb & Greenspan — a growing boutique law firm in Bergen County with a collaborative team and a workplace grounded in our core values: we are ethical, respectful of all people, accountable, positive and fun, driven, and committed to excellence . You'll receive comprehensive training in all aspects of the arbitration process and play a key role in supporting our legal efforts to ensure fair reimbursement for healthcare providers.
Software Engineer (Salesforce) (US REMOTE) Motorola Solutions IncSoftware Engineer (Salesforce) (US REMOTE)NJRemote$100,000–$110,000 / yearRequired Skills & Qualifications: Salesforce Certifications (preferred): Salesforce Certified Application Architect, Salesforce Certified Advanced Developer, Salesforce Revenue Cloud Consultant, Salesforce CPQ Specialist, or equivalent. Integration & Maintenance: Design and develop integrations between Salesforce and other enterprise systems (ERP, marketing automation, etc.) using tools like MuleSoft, REST/SOAP APIs, and middleware platforms.
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.
Coder Northwell Health IncCoderNYWhen determining a team members base salary 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). Analyzes and interprets the medical record in its entirety to ensure accurate, complete and consistent selection of diagnoses and procedures to assure the production of quality healthcare data and accurate facility payment.
DRG Validator Nesco Resource, LLCDRG ValidatorGarden City, NYRemote$95,000–$110,000 / yearThis role is responsible for auditing inpatient medical records to ensure the accuracy of coding, clinical documentation, and DRG assignment while maintaining compliance with applicable coding guidelines and regulatory requirements. Perform concurrent and retrospective clinical, MS-DRG, and APR-DRG validation reviews in accordance with UHDDS, Medicare guidelines, and applicable federal and state regulations.
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.
VP, RCM Business Operations oneOncologyVP, RCM Business OperationsNew York, NY$180,000–$230,000 / yearJob Description: This individual will be responsible for helping coordinate the day-to-day execution of all RCM functions, working with the Chief Revenue Officer ("CRO") and the other RCM Vice Presidents to optimize performance, ensure proactive communication with practices, manage risks and issues along with the overall OO RCM team. OneOncology is positioning community oncologists to drive the future of medical care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer and other diseases.
Full Time Profee Oncology Coder Remote Inventurus Knowledge Solutions LtdFull Time Profee Oncology Coder RemoteNYRemoteOur Care Enablement Platform delivers data-driven value and expertise across the care journey, and IKS is a partner for clinician enterprises looking to effectively scale, improve quality and achieve cost savings through forward-thinking solutions. IKS Health takes on the chores of healthcare, reducing administrative, clinical, and operational burdens so that staff can focus on their core purpose: delivering exceptional care.
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.
Certified Professional Coder (CPC) Lead/Provider Liaison Integrated Resources, IncCertified Professional Coder (CPC) Lead/Provider LiaisonNewark, New JerseyContractorResponsibilities: Operates as the intermediary between the Risk Adjustment Management team and provider-facing staff to report and deliver commercial risk adjustment insightsWorks closely with the Risk Adjustment Management Business Analyst to monitor risk adjustment trends, provider coding performance and member health status using existing tools and performing ad hoc analysisCollaborates with the Network Management leadership in developing, monitoring and driving key performance metrics for Network Management Provider EducatorsCollaborates with the Network Management leadership in developing and delivering commercial risk adjustment educational content and materials for internal and external use, including clinicians and supporting staffValidates documentation against submitted claims diagnosis codes and prepares detailed reportsSupports Risk Adjustment Data Validation auditsDrives communication with pertinent staff and managers to ensure that interdependencies between the departments, other projects and functional work streams are accurately identified and addressedProvides status reports to managementQualificationsCertifications:AAPC Certified Professional Coder (CPC) or AHIMA Certified Coding Specialist (CCS)Knowledge:Understands key tenets of commercial risk adjustment and the HHS-HCC risk adjustment model Mastery of medical coding best practices Project management skills Experience displaying ability to think analytically Strong communications and presentation skills Computer skills: Outlook, Excel, Word & Powerpoint Location could be: Newark, NJ OR West Trenton OR Ewing OR Wall, NJDuration: Contract to HireJob Summary:The Provider Liaison is accountable for extracting insights specific to providers and provider groups regarding commercial risk adjustment and developing educational materials for Network Management professionals to communicate with providers and staff regarding client's risk adjustment programs.
Field Reimbursement Manager (Seattle, Denver or Salt Lake City) Recordati SpAField Reimbursement Manager (Seattle, Denver or Salt Lake City)Bridgewater, NJRemoteServe as subject matter experts on issues of coverage, access and reimbursement by providing compliant, limited support to US health care providers (HCPs) and their office staff in navigating the reimbursement landscape for products of Recordati Rare Diseases Inc. (RRD) after the HCP made an independent decision to prescribeCollaborate with HCP staff and Specialty Pharmacy to follow up with accounts that have outstanding prior authorization or appeals submissions. The FRM is responsible for providing access and reimbursement education to healthcare providers (HCPs)and office personnel, including information regarding medical policies, prior authorization requirements, coding and billing, product access via buybill or specialty pharmacy with the goal of minimizing barriers to therapy.
Medical Assistant Practice Lead | Ophthalmology |Full-Time Day Shift | 25340 Bergen New Bridge Medical CenterMedical Assistant Practice Lead | Ophthalmology |Full-Time Day Shift | 25340Paramus, New JerseyAdditionally, we are committed to the personal and professional growth of our employees, offering robust tuition reimbursement and continuing education programs to help support our employees ongoing development. If you’re passionate about making a difference and thrive in a collaborative setting, Bergen New Bridge Medical Center is looking for a Medical Assistant Lead.
Medical Asst. Practice Lead - Ambulatory Care Center -Specialty (4684) | Full-Time Day Shift (25406) Bergen New Bridge Medical CenterMedical Asst. Practice Lead - Ambulatory Care Center -Specialty (4684) | Full-Time Day Shift (25406)Paramus, New JerseyAdditionally, we are committed to the personal and professional growth of our employees, offering robust tuition reimbursement and continuing education programs to help support our employees ongoing development. If you’re passionate about making a difference and thrive in a collaborative setting, Bergen New Bridge Medical Center is looking for a Medical Assistant Practice Lead.
Claims Adjudication Associate Capital Rx, Inc.Claims Adjudication AssociateNew York, NY$98,800–$123,500 / yearJudi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including: Judi Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers, Judi Health, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and. Manage and prioritize escalated claims-related workflows, including appeals, subrogation, payment issues, stop-loss, adjustments, and member/provider inquiries, based on contractual obligations, regulatory requirements, business risk, and client impact.
CDI Specialist- Remote Med-Metrix, LLCCDI 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.
Billing Coordinator II Opportunities - Long Island New York University School of MedicineBilling Coordinator II Opportunities - Long IslandLong Island, NYCollaborate with the corporate Revenue Integrity Analysts to understand CPT and ICD-10 guidelines, payer policy and procedure manuals, updates, and CMS publications to ensure practices are compliant with current policies and procedures. Detail oriented with high level of accuracy for reviewing charge batch submissions, analyzing and correcting coding denials, preparing, and presenting analyses.
Patient Services Representative UnitedHealth Group IncPatient Services RepresentativeWest Nyack, NYConsider number of unauthorized or unscheduled absences a pattern of before and after-weekend absences tardiness and early departures and long meal periods in accordance with the policy Promotes a positive work attitude fostering teamwork and acceptance of management decisions Supports on-site training initiative for new Patient Services employees Assist co-workers whenever possible to achieve office goals and patient satisfaction Works independently takes initiative in completing assignments and does so without reminder Completes all miscellaneous work assigned by Director Assistant Director Manager Supervisor Team Leader or Physician accurately and in a timely manner Opens office as needed turns on copiers terminals and printers and updates computer for current days session Communicate with clinical staff to keep patient informed of appointment status Verifies insurance eligibility and coverage by phone independent website RTE or EPIC at time of service Verifies patient demographic and insurance information at time of visit. Act on notations and complete the check in process successfully Schedules Cancels Reschedules patient appointments as ordered by the physician adhering to scheduling policies and procedures Obtains HMO insurance referrals as required for maximum reimbursement of services rendered Notifies management or other departments appropriately using Clerical Templates for various issuesrequestsreasons Maintains supply inventories and equipment necessary for the effective performance of the job communicates supply needs to the office supervisor in a timely manner Maintains a neat organized orderly environment in the reception and waiting room areas including physician business cards brochures signage etc Closes office as needed ensuring all patients accounted for and discharged.
Medical Biller / Reimbursement Coordinator McKesson CorporationMedical Biller / Reimbursement CoordinatorEdison, NJ$17.44–$23.53 / hourResponsibilities Key Responsibilities:- Submit and follow up on insurance claims (commercial, Medicare, Medicaid)- Verify patient insurance eligibility and benefits- Review and resolve claim denials and rejections promptly- Manage accounts receivable and aging reports- Post payments and reconcile accounts accurately- Coordinate prior authorizations for chemotherapy, infusions, and specialty medications- Ensure compliance with coding and billing regulations (ICD-10, CPT, HCPCS)- Communicate effectively with patients, providers, and insurance companies regarding billing inquiries- Maintain accurate and up-to-date patient billing records Qualifications Qualifications:- Minimum 2+ years of medical billing experience (oncology/hematology preferred)- Strong knowledge of insurance guidelines, reimbursement processes, and prior authorizations- Relevant certifications such as Certified Professional Biller (CPB), Certified Coding Specialist (CCS), or Certified Professional Coder (CPC) are preferred but not required.- Familiarity with oncology-specific billing (infusion services, J-codes, drug billing) is highly desirable- Experience with EHR/PM systems (e.g., Athena, Centricity, ONCOEmr)Preferred Skills:- Experience handling high-dollar claims and specialty drug reimbursement- Knowledge of Medicare guidelines for oncology services- Ability to work independently and as part of a team in a fast-paced environmentPHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
Manager, Clinical Bus Amin Columbia UniversityManager, Clinical Bus AminNew York, NYMaster's degree in healthcare administration, business administration, finance, accounting, or a related field preferred, with experience in an academic medical center, hospital, faculty practice organization, or similarly complex healthcare environment, and knowledge of healthcare operations, revenue cycle workflows, billing processes, clinical support arrangements, and related administrative practices strongly preferred. The Manager of Clinical Business Administration partners with operational stakeholders to monitor performance, audit billing and coding compliance, resolve issues, reduce risk, and identify opportunities to improve revenue and efficiency, while also supporting business planning and managing key affiliate agreements, contracts, and practice initiatives.
Patient Financial Coordinator #Full Time 61st Street Service CorpPatient Financial Coordinator #Full TimeNew York, NY$24.76–$33.17 / hourThis position acts as a crucial member of our patient care teams to coordinate the financial aspects of the patient’s care, while working together with our other dedicated team members in creating a positive and memorable patient experience. The PFC serves as a resource to patients regarding financially related matters such that they are accessible to patients for ongoing questions regarding this aspect of their care.
Revenue Cycle Supervisor (Self Pay and Specialty) Columbia UniversityRevenue Cycle Supervisor (Self Pay and Specialty)Fort Lee, NJ$66,300–$78,000 / yearDemonstrated skills in A/R management, Customer Service, problem assessment, and resolution, and collaborative problem-solving in complex and interdisciplinary settings, including strong proficiency in healthcare and payer guidelines as it pertains to billing and reimbursement. The Revenue Cycle Supervisor (Self Pay and Specialty) will also be responsible for day-to-day operations of the payment posting process, the International Business Line, Specialty billing, and the oversight of guarantor work queues.
Clinical Statistical Programmer - II (Associate) Clinical Statistical Programmer - II (Associate) MindlanceClinical Statistical Programmer - II (Associate) Clinical Statistical Programmer - II (Associate)Florham Park, NJBachelors, Master or post-graduate degree (eg, PhD, DrPH, PharmD) in Health Economics, Biostatistics, Health Services Research, Public Health, Epidemiology, Pharmacy Administration, or other relevant discipline, with experience in coding and developing analytical datasets and conducting statistical analysis. " Extensive work experience with large US insurance claims databases, electronic medical records, registry databases for health outcomes research (e.g., Premier, IBM-marketscan, THIN European database, Humedica, IMSPharmetrics +, GEhealth, Flatiron, OMNY etc.).
Certified Coder I Hospital for Special SurgeryCertified Coder INew York, NYThe salary of the finalist selected for this role will be determined based on various factors, including but not limited to: scope of role, level of experience, education, accomplishments, internal equity, budget, and subject to Fair Market Value evaluation. Enters ICD-10 and CPT codes and updates patients' information as needed into hospital financial system or computerized department abstracting system which can be used reliably for hospital reimbursement, research, education, and strategic planning.
NewEpic Revenue Cycle Senior Consultant Deloitte Touche Tohmatsu LtdEpic Revenue Cycle Senior ConsultantNew York, NY$116,200–$229,100 / yearPartner with Patient Access, revenue cycle operations, Health Information Management (HIM)/coding, and Patient Financial Services (PFS) leadership to translate requirements into Epic design, manage decision logs and change control, and document build specifications and test scripts. The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs.
Consultant, Outcomes Research Stats Analyst Artech LLCConsultant, Outcomes Research Stats AnalystFlorham Park, NJRemote$84.84 / hourBachelors, Master or post-graduate degree (eg, PhD, DrPH, PharmD) in Health Economics, Biostatistics, Health Services Research, Public Health, Epidemiology, Pharmacy Administration, or other relevant discipline, with experience in coding and developing analytical datasets and conducting statistical analysis. • Extensive work experience with large US insurance claims databases, electronic medical records, registry databases for health outcomes research (e.g., Premier, IBM-marketscan, THIN European database, Humedica, IMSPharmetrics +, GEhealth, Flatiron, OMNY etc.).
Clinical Statistical Programmer - II Integrated Resources, IncClinical Statistical Programmer - IIFlorham Park, NJRemote$80–$86 / hourBachelors, Master or post-graduate degree (eg, PhD, DrPH, PharmD) in Health Economics, Biostatistics, Health Services Research, Public Health, Epidemiology, Pharmacy Administration, or other relevant discipline, with experience in coding and developing analytical datasets and conducting statistical analysis. " Extensive work experience with large US insurance claims databases, electronic medical records, registry databases for health outcomes research (e.g., Premier, IBM-marketscan, THIN European database, Humedica, IMSPharmetrics +, GEhealth, Flatiron, OMNY etc.).
Documentation Improvement Specialist - HYBRID (4 days in Queens office) NYPDocumentation Improvement Specialist - HYBRID (4 days in Queens office)New York, NY$101,000–$151,000 / yearThe Documentation Improvement Specialist is responsible for facilitating improvement of medical record documentation by concurrent and retrospective interventions and interactions with, as well as the provision of education to physicians, residents, and other licensed independent practitioners. In collaboration with Coding Unit expertise, provides in-services to educate therapy staff and clinicians on the following but not limited to: correct billing, coding and documentation through clear verbal and/or written communication.
Revenue Integrity Analyst, CDM -Revenue Integrity- Corporate-Full-Time Days- Hybrid Mount Sinai Health SystemRevenue Integrity Analyst, CDM -Revenue Integrity- Corporate-Full-Time Days- HybridNew York, NY$79,720–$119,580 / yearThe Revenue Integrity Analyst, Charge Description Master (CDM) for the Mount Sinai Health System (MSHS) and the Icahn School of Medicine at Mount Sinai (ISMMS) (which includes the MSHS and the Faculty Practice Plan) combines advanced financial analysis with a strong hospital healthcare revenue cycle background to ensure an accurate and compliant Chargemaster. 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 Auditor - Remote Sprinter Health IncMedical Auditor - RemoteNYRemote$33–$36 / hourOur team of clinicians, technologists, and operators have raised over $125M to date from investors like a16z, General Catalyst, GV, and Accel and enjoy multi-year runway. Most of all, you're energized by the chance to make a real difference - ensuring that accurate, ethical coding supports Sprinter Health's mission to deliver care where patients need it most.
Senior DRG Auditor Disputes Cohere Health Technologies LLCSenior DRG Auditor DisputesNYRemote$85,000–$100,000 / yearBacked by leading investors such as Deerfield Management, Define Ventures, Flare Capital Partners, Longitude Capital, and Polaris Partners, Cohere Health drives more transparent, streamlined healthcare processes, helping patients receive faster, more appropriate care and higher-quality outcomes. By unifying pre-service authorization data with post-service claims validation, we're creating a transparent healthcare ecosystem that reduces waste, improves payer-provider collaboration and patient outcomes, and ensures providers are paid promptly and accurately.
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.
NewProspective Auditor The Jacobson GroupProspective AuditorNew York, NYJob DescriptionThis role supports an ongoing Medicare and Medicare Advantage risk adjustment initiative, focused on validating diagnosis codes to the highest level of specificity. Active coding certification required (one of the following): CPC, CRC, CPMA, CDEO, CCS, CCS‑P, RHIA, RHIT, or CCDS.Strong attention to detail and documentation review skills.
CDI DRG Downgrade Specialist- Remote Med-Metrix, LLCCDI DRG Downgrade Specialist- RemoteParsippany-Troy Hills, NJRemoteThe Clinical Documentation Integrity DRG Downgrade Specialist serves as an effective change agent, acting as a resource and educator for providers and interdisciplinary care teams to improve documentation quality, coding accuracy, and audit readiness. 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.
NewClinical Research Reimbursement Compliance Analyst - Cardiology Mount Sinai Health SystemClinical Research Reimbursement Compliance Analyst - CardiologyNew York, NY$65,885–$98,827 / yearBachelor's degree in Health Information Management (HIM), Healthcare Administration, Medical Coding, Business Administration, Public Administration, Healthcare Management, or related field with coursework relating to healthcare operations includes the following topics: Medical Terminology, Human Anatomy and Physiology, ICD-10 Coding, and CPT Coding, or closely related courses. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics, top 5 in Cardiology/Heart Surgery, and top 20 in Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology.
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.
NewRemote Market Access Director Major Accounts LantheusRemote Market Access Director Major AccountsBrooklyn, NYRemote$172,000–$287,000 / yearSummary Of RoleThe National Accounts Market Access Director will partner with key academic centers, large Integrated Delivery Networks (IDN) and large groups to ensure favorable portfolio access in support of Lantheus' broader market access strategy. The successful candidate will engage with key decision makers to implement and pull through market access strategies while also serving as an integral part of the site setup process for adopting Lantheus' potential new products with several upcoming launches.
AI Engineer Joyful HealthAI EngineerNew York City, New YorkThe healthcare payment system is a complex and inefficient maze - healthcare practices leave $125 billion in revenue uncollected each year, lost in the chaos of fragmented financial data, manual workflows, and opaque payer systems. We're looking for a talented and ambitious machine learning engineer with 5+ years of experience building production AI systems who's excited to solve one of the toughest challenges in healthcare - automatically resolving claim denials.
Certified Medical Assistant (CMA) – Regional Drug Dependency Unit Akicita FederalCertified Medical Assistant (CMA) – Regional Drug Dependency UnitKearny, NebraskaThis role is responsible for assisting with patient care activities, performing routine clinical tasks, managing patient records, and supporting the overall operation of the unit, ensuring compassionate, culturally sensitive care for individuals undergoing substance abuse treatment. $50,000 - $65,000 a year Position Summary The Certified Medical Assistant (CMA) will provide clinical and administrative support to the healthcare team in the Regional Drug Dependency Unit (RDDU) at the Great Plains Area facility in Winnebago, NE.
Billing Services Representative Saint Peter's Healthcare System IncBilling Services RepresentativePiscataway, NJReview outstanding accounts using ATB/queues/payments reports/halt report/electronic billing edits/credit balances. Use technology provided (including hospital information system, contract management system, electronic billing system, payer websites and document imaging system.).
Accounts Receivable Representative I Hospital for Special SurgeryAccounts Receivable Representative INew York, NYThe salary of the finalist selected for this role will be determined based on various factors, including but not limited to: scope of role, level of experience, education, accomplishments, internal equity, budget, and subject to Fair Market Value evaluation. Maintains Documentation & Manages Information- Maintains tracking logs Creates and maintains tracking logs for Insurance Payor issues and accountability for closing out items.
Medical Scribe CVS Health CorpMedical ScribeBrooklyn, NY$17–$34.15 / hourScribes receive extensive on-the-job training in clinical workflows, value-based medicine, preventative care for chronic conditions, accurate and specific documentation, population health data streams, and team based care. Role Description: The purpose of a Clinical Informatics Specialist (CIS or Medical Scribe) Float at Oak Street Health is to support our primary care providers with clinical documentation so that they can focus on providing exceptional care to our patients.
NewMedical Scribe - Bilingual Spanish Prefered CVS Health CorpMedical Scribe - Bilingual Spanish PreferedBronx, NY$17–$34.15 / hourScribes receive extensive on-the-job training in clinical workflows, value-based medicine, preventative care for chronic conditions, accurate and specific documentation, population health data streams, and team based care. This is an excellent opportunity for pre-med track individuals looking to gain practical, paid experience in a clinical setting before applying to an MD/DO/PA/NP program, as well as those pursuing careers in Health Informatics, Public Health, Healthcare Administration, Medical Coding, and other related fields.