Office Manager (Yonkers) Cordial HealthOffice Manager (Yonkers)Yonkers, New YorkThe Office Manager will oversee both front-office and back-office functions, ensuring efficient patient flow, accurate billing, compliant operations, and a positive experience for patients and providers. We are seeking an experienced and highly organized Office Manager to lead daily operations for a fast-growing Neurology and Psychiatry medical practice in Yonkers, New York.
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.
Inpatient Medical Coder – PRN – Up to $1,000 Sign on Bonus DatavantInpatient Medical Coder – PRN – Up to $1,000 Sign on BonusNew York City, NYRemote$32–$42 / hourThe estimated base pay range per hour for this role is: $32—$42 USD To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc. 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.
Inpatient Medical Coder – FT – Up to $5,000 Sign on Bonus DatavantInpatient Medical Coder – FT – Up to $5,000 Sign on BonusNew York City, NYRemote$32–$42 / hourThe estimated base pay range per hour for this role is: $32—$42 USD To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc. 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.
Medical Billing Manager - Compliance MercorMedical Billing Manager - ComplianceNew York, New YorkRemoteManage claims submission workflows including electronic claim generation, clearinghouse edits, and payer-specific billing requirements. Coordinate with coding, CDI, and collections teams to resolve billing edits and claim rejections.
NewMedical Billing Specialist (GSD) ConnectAmerica LLCMedical Billing Specialist (GSD)NJThe purpose of the Medical Billing Specialist role is to: Support our life-saving Lifeline products by using your medical billing and collecting experience to obtain maximum reimbursement while establishing strong relationships with insurance companies and customers. With the easy-to-use personal emergency response, remote patient monitoring and medication management systems, Connect America/Lifeline processes more than 250,000 emergency signals and data transmissions each month and has protected more than 1 million lives.
Special Investigations Unit Clinical Certified Coder Metroplus Health Plan IncSpecial Investigations Unit Clinical Certified CoderNew York, NY$100,000–$110,000 / yearMetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth network includes over 27,000 primary care providers, specialists and participating clinics.
Surgical Commercial Billing & Collections Specialist Human HireSurgical Commercial Billing & Collections SpecialistClifton, NJ$26–$30 / hourYoull be working in a fast-paced, specialty-driven setting supporting neuro-spine, orthopedic, and podiatry surgical billing where accuracy, persistence, and strong payer knowledge directly impact reimbursement outcomes. Youll gain deep exposure to complex commercial payer strategies, out-of-network reimbursement negotiation, and high-dollar surgical billing workflows in a specialized clinical environment.
Medical Biller ANNA K IMPERATO MD PLLCMedical BillerMANHASSET, NYFull timeAs a Medical Biller, you will be working closely with clients to answer questions related to billing, processing all forms needed for insurance billing purposes, and collecting necessary documentation from clients. You will also assist other Medical Billers with follow-up inquiries to clients, communicate with physicians' offices and hospitals to obtain records, and accurately record patient information.
Revenue Integrity Coordinator Westchester Medical Center Health NetworkRevenue Integrity CoordinatorValhalla, NY$32.95–$41.42 / hourJob Category Job Category Advanced Clincial Providers Advanced Practice Providers Allied Health Prof/Technical Clerical/Administrative Support clerical/Administrative Supportc Executive/Management Finance/Info Systems Nursing Support Nursing/Nursing Management Physicians Professional/Non-Clinical Service/Trades. Company Company Bon Secours Charity Medical Group Bon Secours Community Hospital Good Samaritan Hospital HealthAlliance Hospital Margaretville Hospital MidHudson Regional Hospital Mountainside Residential Care Center NorthEast Provider Solutions Inc.
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.
Sr. Revenue Cycle Billing Specialist Firstsource Solutions LtdSr. Revenue Cycle Billing SpecialistNY$30–$40 / hourThis role identifies root causes of denials, executes appeals and corrective actions, and collaborates with internal teams to prevent future denials. Work claims across all top denial categories including, but not limited to: No Authorization, Timely Filing, Coordination of Benefits (COB), Medical Necessity, Additional Documentation Requests (ADR), Bundling (NCCI edits), and Duplicate Claims.
NewRevenue Cycle Specialist-Revenue Integrity Pathology-REMOTE Weill Cornell Medical CollegeRevenue Cycle Specialist-Revenue Integrity Pathology-REMOTENew York, NYRemote$32.69–$36.76 / hourThe CBO partners with WCM Clinical Departments to increase and expedite service revenue, reduce aged AR, and trend denials for their root causes thereby driving efficiencies, to include clinical documentation improvement and coding denials prevention. Resolves outstanding accounts utilizing ancillary applications and websites as tools to retrieve medical documentation, claim status and billing guidelines to substantiate corrected claim submissions, written appeals, coding and medical necessity reviews.
Senior Consultant - Clinical Documentation Specialist Deloitte Touche Tohmatsu LtdSenior Consultant - Clinical Documentation SpecialistStamford, CT$110,700–$218,300 / yearOther skills include the ability to analyze, act and design action plans upon monthly and quarterly reports related to individual providers, facilities, MS-DRGs, APR, PSIs, severity of illness and risk of mortality, capture rates, quality metrics and can effectively prioritize their work activities. Clinical Payments Optimization: Assisting clients by validating that payments for clinical healthcare services comply with regulatory, clinical based evidence and contractual requirements while also determining that payments are appropriate for the type and level of care provided.
Inpatient Coder (Remote) Nesco Resource, LLCInpatient Coder (Remote)Garden City, NYRemote$60,000–$65,000 / yearResponsibilities include, but are not limited to: Assign ICD-10-CM/PCS diagnosis and procedure codes in accordance with Official Coding Guidelines, AHA Coding Clinic, CMS, and other regulatory requirements. The Inpatient Coder is responsible for accurately coding and abstracting diagnoses, procedures, and clinical information from inpatient medical records.
Diagnosis Related Group Clinical Validation Auditor-Rn (Cdi, Ms-Drg, Ap-Drg And Apr-Drg) Elevance HealthDiagnosis Related Group Clinical Validation Auditor-Rn (Cdi, Ms-Drg, Ap-Drg And Apr-Drg)New York, NY$82,232–$155,808 / 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. Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5 years of experience working with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG; or any combination of education and experience, which would provide an equivalent background.
Certified Professional Coder, Special Investigations Unit (Aetna SIU) CVS Health CorpCertified Professional Coder, Special Investigations Unit (Aetna SIU)NJ$43,888–$93,574 / yearThe Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. Uses department resources regularly and follows workflows with minimal assistance or intervention to perform daily work to meet metrics.
Health Economics Manager, Peripheral Vascular Stryker CorpHealth Economics Manager, Peripheral VascularWhite Plains, NYRemote$118,000–$196,700 / yearThe Area HEMA Manager works independently, supporting the reimbursement and market access development to improve access for patients, providers, and payors to the organization's technology and product portfolio, as well as the primary expert in the field in all areas related to reimbursement of the company's products. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information.
Medical Assistant - Brooklyn Human HireMedical Assistant - BrooklynBrooklyn, 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. Responsibilities include patient intake, clinical and laboratory support, diagnostic testing, EMR documentation, and assisting providers in a fast-paced outpatient setting.
Medical Assistant - Brooklyn (Float West) Human HireMedical Assistant - Brooklyn (Float West)Brooklyn, 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. Responsibilities include patient intake, clinical and laboratory support, diagnostic testing, EMR documentation, and assisting providers in a fast-paced outpatient setting.
Senior Inpatient Coder Westchester Medical Center Health NetworkSenior Inpatient CoderValhalla, NY$39.66–$49.86 / hourJob Details: Job Summary: The Senior Inpatient Coder is responsible for addressing appeals to insurance companies and coding highly complex medical records using the current International Classification of Diseases (ICD10 CM/PCS codes) and entering coded information into an automated grouper system. Job Category Job Category Allied Health Prof/Technical Clerical/Administrative Support clerical/Administrative Supportc Executive/Management Finance/Info Systems Nursing Support Nursing/Nursing Management Physicians Professional/Non-Clinical Service/Trades.
NewSenior Medical Accounts Receivable Specialist The Cardiovascular Care GroupSenior Medical Accounts Receivable SpecialistClifton, NJThe Senior AR Specialist is responsible for managing complex accounts receivable activities, resolving outstanding insurance and patient balances, and ensuring timely reimbursement for cardiovascular services. The ideal candidate possesses extensive medical accounts receivable experience, strong analytical skills, and a comprehensive understanding of physician practice billing, payer requirements, and healthcare reimbursement methodologies.
Strategic Medical Director, PM&R / Post-Acute Care & DME Cohere Health Technologies LLCStrategic Medical Director, PM&R / Post-Acute Care & DMENYRemote$285,000–$305,000 / yearProvide physician leadership in the creation of comprehensive research packages, investigating specific clinical areas/offerings and strategic partners of interest to strengthen the offering, then execute on cultivating any external partnerships and/or vendor relationships as necessary. Build and expand client relationships by partnering with the Growth and Client Experience teams to uncover client pain points, deliver solutions, assign clients to managers as appropriate, and support upsell opportunities (e.g., Sleep programs).
NewEverHealth - RCM Service Manager (Remote, US) EverCommerce IncEverHealth - RCM Service Manager (Remote, US)NYRemote$50,000–$60,000 / yearAs a leading service commerce platform, our modern digital and mobile applications create predictable, informed, and convenient experiences between customers and their service professionals in the areas of Home & Field Services, Health Services, and Wellness industries. The RCM Service Manager partners closely with internal billing, claims, coding, vendor, and operations teams to ensure timely and accurate revenue cycle execution.
Compliance Auditor Talkspace IncCompliance AuditorNew York, NYRemote$77,000–$92,000 / yearWe encourage you to apply, even if you don't meet every qualification or if your path has been nontraditional - such as not completing a formal degree program, taking a career break, or having a prior criminal record - if you believe you could make a great addition to this team. Combining our passion for innovation along with our desire to help others overcome the stigma behind "getting help," we are transforming the way patients find the right care provider, making an otherwise impossible feat easily conquerable.
Medical Billing Specialist #3467640 Blackbird RecruitingMedical Billing Specialist #3467640Monsey, New YorkOur client is currently seeking an experienced and detail-oriented Medical Biller to join our team in Monsey, NY . The ideal candidate will have a strong background in medical billing, insurance claim processing, and accounts receivable follow-up.
Senior Manager, Field Reimbursement PhilipsSenior Manager, Field ReimbursementNY$133,000–$212,000 / yearYour skills include demonstrated outstanding knowledge and strong understanding of US healthcare coding and billing systems, Medicare and commercial payers, hospital infrastructure, reimbursement policies and processes, and possesses expertise in data analysis, health economic evidence, and documentation. The Senior Manager, Field Reimbursement leads customer education and engagement on coding, coverage, payment, and payer policy for Philips Image Guided Therapy Device products, helping reduce reimbursement and economic barriers for U.S. patients and providers.
Facility-Fee Emergency Department Medical Coder Sutherland Global Services IncFacility-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.
Insurance Authorization Specialist - East Meadow Human HireInsurance Authorization Specialist - East MeadowEast Meadow, 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!
Insurance Authorization Specialist - White Plains Human HireInsurance Authorization Specialist - White PlainsWhite Plains, 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!
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.
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.).
Insurance Specialist Regional Cancer Care AssociatesInsurance SpecialistTeaneck, New Jersey$18.99–$29.22 / hourWhile performing the duties of this job, the employee is required to be present at the employee site during regularly scheduled business hours and regularly required to sit or stand and talk or hear. The position requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination.
Insurance Specialist I Regional Cancer Care AssociatesInsurance Specialist IHackensack, New Jersey$18.99–$29.22 / hourWhile performing the duties of this job, the employee is required to be present at the employee site during regularly scheduled business hours and regularly required to sit or stand and talk or hear. The position requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination.
Medical Biller Javier Zelaya MD PCMedical BillerBrooklyn, New YorkThe team provides medical dermatology treatment options and full body screenings for a number of skin conditions including melanoma and other skin cancers, acne, rosacea, eczema, psoriasis, cysts, skin rashes and allergies, hyperpigmentation, aging skin, photodamage, vitiligo, warts, sweat, hair loss and more. Board certified Dermatologist and Internist, Dr. Javier Zelaya, with over 25 years of dermatology, cosmetic, laser and surgical experience works alongside a skilled team Physician Assistants, Nurse Practitioners and licensed Medical Esthetician.
MEDICAL PRACTICE MANAGER CenterLight Healthcare Pace CenterMEDICAL PRACTICE MANAGERBrooklyn, NY$80,000–$95,000 / yearMinimum of one (1) year of experience working with a frail or elderly population or, if the individual has less than one (1) year of experience but meets all other requirements, must receive appropriate training from the PACE organization on working with a frail or elderly population upon hiring. Audio Hearing and Motor Skills (language) Requirements - Must be able to listen attentively and document information from patients, community members, co-workers, clients, providers, etc., and intake information through audio processing with accuracy.
Chinese Speaking Medical Biller CbChinese Speaking Medical BillerFlushing, New York$25–$35 / hourAs a Medical Biller, you will be working closely with patients to answer questions related to billing, processing all forms needed for insurance billing purposes, and collecting necessary documentation from patients. You will also assist and follow-up inquiries to patients, communicate with physicians' offices and hospitals to obtain records, and accurately record patient information.
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.
Sr. Certified Coder Information Consulting ServicesSr. Certified CoderBrunswick, NJ$31.36–$50.17 / hourCertified Coder will: In accordance with established coding principals and guidelines assigns appropriate diagnosis and procedure codes to all applicable records - (concurrently/discharge) on patient units. We offer competitive base rates that are determined by many factors, including job-related work experience, internal equity, and industry-specific market data.
Senior Compliance Auditor Montefiore Medical CenterSenior Compliance AuditorNY$81,600–$102,000 / yearDevelops and conducts documentation, coding and billing curriculum and education classes for 500 + physicians, allied health professionals, and coding and billing associates annually, including: One-on-one education sessions based on audit findings. Safeguards Montefiore Medical Center revenue and reputation, through the following activities: Participates in external government audits, including: NY Office of Medicaid Inspector General (OMIG).
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.
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.
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!
Palliative Care Nurse Practitioner CompassusPalliative Care Nurse PractitionerParamus, NJThe Palliative Care Nurse Practitioner provides palliative care for patients facing chronic, complex, and /or life-threatening conditions at various locations within the flow of patient care. Meaningful Work: Make an impact every day by honoring the quality of life of our patients, supporting them and their families with compassion, and creating moments that truly matter.
Clinical Nurse Reviewer Zelis Healthcare, Inc.Clinical Nurse ReviewerMorristown, NJ$59,000–$75,050 / yearThe Nurse Reviewer is primarily responsible for conducting post-service, pre or post payment in-depth claim reviews based on accepted medical guidelines and clinical criteria, billing and coding rules, plan policy exclusions, and payment errors/overpayments. 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.
Manager, Electrophysiology - Physician Practice Hackensack Meridian HealthManager, Electrophysiology - Physician PracticeHackensack, New JerseyFull timeResponsibilities: A day in the life of a Manager of Electrophysiology at Hackensack Meridian Health includes: Oversees all areas of patient's non-clinical experience including telephone communications, patient scheduling, patient reception, patient check-in and check-out, pre-certifications, referrals, and managing the EMR. 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.
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 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.
Supervisor, Cancer Care Coordination St. Joseph HealthSupervisor, Cancer Care CoordinationPaterson, NJThe combined efforts of the organization's outstanding physicians, superb nurses, and dedicated clinical and professional staff have made us one of the most highly respected healthcare organizations in the state, the largest employer in Passaic County, and one of the nation's "100 Best Places to Work in Health Care". St. Joseph's University Medical Center is an academic tertiary care medical center and state designated trauma center, located on the Paterson campus, regularly accepts referrals of difficult or unusual cases from other hospitals and physicians and performs both complex and routine procedures.
DRG Clinical Validation Lead Elevance HealthDRG 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.