SIU Investigator Centene Corporation GroupSIU InvestigatorNJ$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.
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.
Employed Optometrist- New York, NY- LensCrafters EssilorLuxottica SAEmployed Optometrist- New York, NY- LensCraftersNew York, NY$65.19–$91.39 / hourIf 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.
Care Enrichment Coach Ocean Health Initiatives IncCare Enrichment CoachLakewood, NJProficient in Phreesia EMR: Assist with sending telehealth links to patients when requested, notify patients of provider schedule changes via automated alerts, and handle appointment cancellation requests efficiently. Upload previous patient medical records from prior and specialty providers, provide copies of medical records to patients upon request, and share records with other providers and hospitals as necessary for continuity of care, in compliance with organizational policies.
Psychiatrist HCP TalentPsychiatristNew YorkOperating on a predictable, daytime schedule, this position allows you to make a profound clinical impact while working alongside a highly collaborative, multidisciplinary team. Partner and coordinate closely with primary care providers, specialists, and behavioral health staff to ensure seamless continuity of care.
Director, Patient Access & Revenue Cycle RWJ Barnabas Health Medical IncDirector, Patient Access & Revenue CycleNewark, NJ$133,924–$189,167 / yearAchieve goal of reducing bill hold days below target by leading revenue cycle committee meetings with members of finance, clinical departments, coding, and revenue integrity. Job Overview: The Director of Patient Access and Revenue Cycle Services is responsible for the comprehensive leadership, management, and strategic direction of all hospital patient access/revenue cycle operations.
Claims Specialist- Liab Crawford & CoClaims Specialist- LiabBerkeley Heights, NJTo determine the actual offer, Crawford considers a wide range of factors including the candidate's previous experience and education, market rates, minimum pay requirements for the applicable jurisdiction, business segment, supply/demand, and scheduled hours. Verifies policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves within designed authority, as necessary, during the processing of the claim.
Applied AI Scientist, Clinical AI Agents R37 Lab, R1 RCMApplied AI Scientist, Clinical AI AgentsNew York, New YorkPhare Health is now part of R1 and its AI innovation engine, R37 Lab , bringing Phare’s frontier clinical reasoning technology together with one of the largest healthcare platforms in the U.S. At R37 and Phare, we are building the first AI-native Healthcare Revenue Operating System : a connected platform that reasons over full medical records, payer logic, and financial workflows to automate medical coding, billing, and follow-up. You will be embedded in hard healthcare problems — clinical documentation integrity, medical coding, denial prevention, appeals, revenue cycle workflows, and payer logic — and will own the loop from problem framing to agent design, evaluation, deployment, trace analysis, and ongoing improvement.
Director, Provider Education & Risk Adjustment Metropolitan Jewish Health SystemDirector, Provider Education & Risk AdjustmentNew York, New YorkFull timeThey are responsible for implementation of strategic plans and coordination of all aspects of provider and practice education, including but not limited to scheduling, tracking, follow-up, workflow integration, medical record documentation, coding, and electronic health records. • Analyze medical record documentation and coding through a chart review process that identifies incorrect coding, coding lacking supporting documentation, and missed opportunities to capture risk adjustment diagnoses and associated revenue.
IBR Senior Analyst Zelis Healthcare, Inc.IBR Senior AnalystNJ$79,000–$99,750 / yearThis is a place for builders with a growth mindset who act with agility, embrace change, and use modern technology to shape smarter solutions, exceptional experiences, and the future of our industry for our clients, customers, and our culture. The Itemized Bill Review Senior Analyst will be responsible for analyzing hospital claims for adherence to proper billing guidelines and will work closely with Expert Claims Review staff to efficiently adhere to policies and procedures for claims processing.
Registered Nurse (RN) - Home Visits Help at Home LLCRegistered Nurse (RN) - Home VisitsForest Hills, NYOverview\n \nAs the nation's leading provider of high-quality home care services, we empower our clients to live independently, safely, and with dignity in their own homes. One year of nursing experience.\n \nThe above statements are intended to describe the general nature and level of work being performed by people assigned to this classification.
Risk Adjustment Expert - Fully Remote MercorRisk Adjustment Expert - Fully RemoteNew York, New YorkRemote5+ years of experience in risk adjustment coding , HCC coding , or Medicare Advantage coding operations , with at least 2 years in a leadership role. Lead risk adjustment and HCC coding operations across Medicare Advantage , Medicaid , and ACA risk adjustment programs.
CDI Specialist Episcopal Health Services IncCDI SpecialistNYAdditionally, St. Johns 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.
Community Pharmacy Team Lead (Thursday to Saturday, 10:00AM - 6:30PM ET) AnewHealthCommunity Pharmacy Team Lead (Thursday to Saturday, 10:00AM - 6:30PM ET)NJRemoteAbility 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.
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.
NewClinical 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.
Manager, Data Mining - Payment Integrity Oscar Health InsuranceManager, 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.
Mgr Multi Facility CDI SMNJ Medical Records FAC#1 Prime Healthcare Services IncMgr Multi Facility CDI SMNJ Medical Records FAC#1Newark, NJCombining state-of-the-art technology, the latest diagnostic and therapeutic procedures, leading-edge research, and a network of highly qualified physicians, nurses, and allied health professionals, the hospital provides top-quality health care services delivered with compassionate care. Established by the Franciscan Sisters of the Poor in 1867, Saint Michael''s Medical Center is a 358-bed regional tertiary-care, teaching, and research center in the heart of Newark''s business and educational district and is accredited by The Joint Commission.
Psychotherapist (LPC/LCSW/LMFT/Art Therapist) Konnect TherapyPsychotherapist (LPC/LCSW/LMFT/Art Therapist)Iselin, New Jersey$40–$60Demonstrated expertise in psychotherapy techniques such as motivational interviewing, behavioral therapy, psychodynamic therapy, grief counseling, PTSD care, addiction counseling, and crisis management. Deliver individual, group, and family counseling sessions utilizing modalities such as cognitive behavioral therapy (CBT), psychodynamic therapy, art therapy, DBT, TF-CBT, ERP, EMDR.
Clinical Research Billing Analyst VitaliefClinical Research Billing AnalystNew Brunswick, NJ$75,000–$110,000 / yearBy combining deep subject matter expertise with the experience of senior research practitioners, we help organizations accelerate study activation, optimize operations, improve financial performance, and build scalable workforce solutions that reduce costs, increase efficiency, and advance clinical breakthroughs for patients. The Analyst collaborates with Clinical Trial Finance, Revenue Cycle, Research Operations, study teams, investigators, IRB, and other stakeholders to resolve billing issues, improve processes, and ensure accurate, compliant research revenue cycle operations.