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.
NewField Reimbursement Manager, Greensboro NC - Dermatology Johnson & JohnsonField 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.
NewField Reimbursement Manager, Charlotte NC - Dermatology Johnson & JohnsonField Reimbursement Manager, Charlotte 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.
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.
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.
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.
Inpatient Program Strategy & Execution Manager Cohere Health Technologies LLCInpatient Program Strategy & Execution ManagerNYRemote$110,000–$127,000 / yearBy 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. With an enterprise approach that streamlines payer-provider decision-making across the care continuum-including policy, prior authorization, payment accuracy, and more-the company improves collaboration and reduces burden, resulting in up to 8x ROI and 94% provider satisfaction.
Medical Claims Processor GlobalchannelmanagementMedical Claims ProcessorParamus, New JerseyPartner with the clearing house to distribute patient billing statements and monitor the patient portal to post payments in the EHR system. Medical Claims Processor duties: Review medical claims and transmit to the insurance carrier using the practice electronic health records (EHR) system and clearing house.
Inpatient DRG Reviewer Zelis Healthcare, Inc.Inpatient DRG ReviewerNJ$79,000–$99,750 / yearWhere the regrouped 'new DRG' differs from what was originally claimed by the provider, write a customer facing 'rationale' or 'findings' statement, highlighting the problems found and justifying the revised choices of new codes and DRG, based on the clinical evidence obtained during the review. This 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.
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.
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).
Field Reimbursement Manager Zimmer Biomet Holdings IncField Reimbursement ManagerNY$150,000–$175,000 / yearThis individual will act as a trusted partner to both customers and internal teams by delivering compliant reimbursement education, identifying access barriers, supporting coding and billing workflows, and providing field-based insights that inform market access and commercial strategy. The ideal candidate brings deep expertise in medical device reimbursement within pain management, including CPT/HCPCS coding, payer policy, claims submission, prior authorization, appeals and denials, and reimbursement trends affecting emerging or evolving technologies.
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.
NewField Reimbursement Manager, Charlotte NC - Dermatology 6077-Johnson & Johnson HCS Legal EntityField Reimbursement Manager, Charlotte 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.
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.
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.
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.
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.