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.
Appeal Analyst RN I Integrated Resources, IncAppeal Analyst RN IHopewell, NJ$40–$42 / hourStrong knowledge of medical terminology, anatomy and physiology, disease processes, treatment protocols, procedural drug therapies, ancillary services, and diagnostic procedures. Additionally, the role provides guidance and education to stakeholders regarding ICD-10-CM coding, DRG assignment, payment methodologies, and audit processes.
NewDiagnosis Related Group Clinical Validation Auditor-RN (CDI, MS-DRG, AP-DRG and APR-DRG) Elevance Health IncDiagnosis Related Group Clinical Validation Auditor-RN (CDI, MS-DRG, AP-DRG and APR-DRG)New York, NY$86,560–$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.
HIM Coder - OP Atlantic Health SystemHIM Coder - OPPompton Plains, NJAtlantic Medical Group, comprised of 1,000 physicians and advanced practice providers, represents one of the largest multi-specialty practices in New Jersey and includes finance, legal, marketing, human resources, talent acquisition, ISS and more. Atlantic Health scored four “A” grades by The Leapfrog Group in its Fall 2025 Hospital Safety Grades, performance measures reflecting errors, accidents, injuries and injections, as well as systems hospitals have in place to prevent harm.
AI Model Engineer - Remote/Nationwide Signature Performance, Inc.AI Model Engineer - Remote/NationwideNewark, NJRemoteDocument architectural approaches, model behaviors, and best practices for internal knowledge growthMinimum Requirements:Education & Experience- Bachelor's or Master's degree in Computer Science, AI/ML, Engineering, Applied Mathematics, or related field (or equivalent experience).- 3--7+ years of hands-on experience designing, training, or deploying machine learning or deep learning models.- 2+ years of direct experience with large language models, transformer architectures, or agentic AI systems. In the role of AI Model Engineer, you will design, fine-tune, evaluate, and deploy large language models (LLMs), multimodal models, retrieval systems, and agentic frameworks that support high-volume medical coding, billing, claims processing, health insurance discovery, eligibility verification, customer service support, EDI ingestion, and enterprise automation.-
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. This position collaborates closely with the Director of Finance and Revenue Cycle, as well as the Revenue Cycle Manager and Revenue Cycle Supervisor, to ensure the seamless execution of day-to-day operations within the Billing Department.
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.
NewRevenue Cycle Denials Analyst Richmond University Medical CenterRevenue Cycle Denials AnalystStaten Island, NY$60,000–$70,000 / yearFamiliarity with UB-04 facility billing, payer remits, CARC/RARC codes, and OPPS/APC/DRG methodologies strongly preferred. Works with Patient Access, Coding, Utilization Review, Billing, Managed Care, and clinicians to reduce denial root causes.
NewAccess and Reimbursement Manager Omeros CorpAccess and Reimbursement ManagerNY$185,000–$210,000 / yearOmeros' pipeline also includes OMS527, a phosphodiesterase 7 inhibitor in clinical development for cocaine use disorder, which is fully funded by the National Institute on Drug Abuse, and a growing portfolio of novel recombinant antibodies targeting multidrug-resistant organisms and novel molecular and cellular therapeutic programs for oncology. Omeros' lead complement inhibitor YARTEMLEA (narsoplimab-wuug), which targets the lectin pathway's effector enzyme MASP-2, is FDA-approved and commercially available in the U.S. for the treatment of hematopoietic stem cell transplant-associated thrombotic microangiopathy (TA-TMA) in adult and pediatric patients aged two years and older.
Billing Coordinator / Coder Ambulatory - Ears, Nose, and Throat - Physician Practice Hackensack University Medical CenterBilling Coordinator / Coder Ambulatory - Ears, Nose, and Throat - Physician PracticeHackensack, NJThis position is responsible for accurately abstracting data following the Official International Classification of Diseases (ICD)-10-Clinical Modification (CM), Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS) Guidelines for Coding and Centers for Medicare and Medicaid Services (CMS) directives across the Hackensack Meridian Health (HMH) network. The Billing Coordinator / Coder is responsible for coordinating the day-to-day billing operations of the department and the hospital outpatient billing service utilizing a centralized medical information system.
Patient Account Representative Med-Metrix, LLCPatient Account RepresentativeRed Bank, NJPhysical 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. Ability to use various workflow system and client host system such as STAR, SMS, EAGLE and EPIC, as well as other tools available to them to collect payments and resolve accounts.
Patient Account Representative - Remote Med-Metrix, LLCPatient Account Representative - RemoteRed Bank, NJRemotePhysical 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. Ability to use various workflow system and client host system such as STAR, SMS, EAGLE and EPIC, as well as other tools available to them to collect payments and resolve accounts.
Chief Radiation Therapist Hunterdon HealthChief Radiation TherapistFlemington, NJPreferred: Knowledge of MOSAIQ EMR systems, Varian TruBeam linear accelerator, brachytherapy procedures and workflows, in addition to radiation oncology coding and billing (ROCC certification) strongly preferred. Responsible for the daily clinical and administrative operations and activities of the radiation oncology department, including directly supervising radiation therapists, nursing and clerical staff, as well as volunteers and student interns.
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.
Insurance Specialist Regional Cancer Care AssociatesInsurance SpecialistHackensack, New Jersey$18.99–$29.22 / hourTemporaryIn this vital role, you will help ensure patients receive the care they need by supporting accurate billing, timely payments, and exceptional service. Reviews reports, identifies denied claims, researches and resolves issues, may perform a detailed reconciliation of accounts, and resubmits claim to payer.
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.
Certified Professional Coder Integrated Resources, IncCertified Professional CoderHopewell, NJ$35–$38 / hourThe role involves designing audit protocols, handling special projects, and performing/finalizing per diem audits, bill verification, DRG validation (utilization review audits), and credit balance reviews. This position is responsible for leading on-site and desk audits of hospital billing and coding practices, including forms development, audit profiling, and tracking institutional audit trends.
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.
NewVice President, Chief Revenue Cycle Officer Atlantic Health System IncVice President, Chief Revenue Cycle OfficerMorristown, NJ$511,524–$708,513 / yearAtlantic Health is seeking an accomplished and visionary Vice President, Chief Revenue Cycle Officer (CRCO) to lead the full spectrum of revenue cycle operations across our growing network of hospitals, physician practices, ambulatory centers, and specialty services. As a key member of the senior leadership team, the CRCO will work closely with clinical, operational, and financial executives to support organizational growth, strengthen reimbursement, and ensure Atlantic Health remains a high‑performing and financially resilient healthcare organization.
Product Security Engineer Candid HealthProduct Security EngineerNew York, NY$180,000–$258,000 / yearMedical billing is expensive because it's nuanced and hard - maybe ~100x harder than credit card payment processing - and because it's traditionally done by armies of humans who track and manage complex rules and processes specific to individual insurance companies with little or no supporting software. We're rethinking medical billing from the ground up, building software backed by best-in-class data science (and, soon, a dash of machine learning) to automate much of this complexity so healthcare providers can get paid dramatically more easily and inexpensively.
Revenue Integrity Analyst (FGP) - Manhattan, CBO North Billing (CPC highly preferred) NYU Langone Medical CenterRevenue 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. Reporting to the Assistant Director, Professional Billing, the Revenue Integrity Analyst is responsible for managing, coordinating, and implementing charge capture initiatives and processes to improve revenue management and revenue protection and ensures the overall integrity of the charge capture process.
Assistant Director (FGP), Revenue Optimization & Analytics - Radiology, Manhattan NYU Langone Medical CenterAssistant Director (FGP), Revenue Optimization & Analytics - Radiology, ManhattanNew York, NY$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.
Remote | Healthcare Denials & Appeals Review Consultant — Up to $70/hour 24-MagRemote | Healthcare Denials & Appeals Review Consultant — Up to $70/hourNew York, New YorkRemoteWe are sharing a specialised part-time consulting opportunity for United States-based healthcare revenue cycle professionals experienced in denials management, appeals operations, payer denial analysis, clinical and technical appeals, denial prevention, revenue recovery, and healthcare billing workflows. This role supports current and upcoming remote consulting opportunities focused on AI-assisted denials management evaluation, appeal content review, payer denial workflow assessment, root cause analysis, and high-quality project execution.
Quality Analyst - Outpatient, Healthcare ExlService Holdings IncQuality Analyst - Outpatient, HealthcareNYRemote$85,000–$92,000 / yearEXL never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process and has not authorized any agencies or partners to collect any fee or payment from prospective candidates. EXL harnesses the power of data, analytics, AI, and deep industry knowledge to transform operations for the world's leading corporations in industries including insurance, healthcare, banking and financial services, media and retail, among others.
Urgent Requirement - Certified Professional Coder Integrated Resources, IncUrgent Requirement - Certified Professional CoderEwing Township, New JerseyFull timeRequires current Registered Health Information Technologies (RHIT) or Certified Professional Coder designation from the American Academy of Professional Coders or a Certified Coding Specialist from the American Health Information Management (AHIMA). Handle internal and external areas requests to investigate current state and historical of changes made to a particular CPT-4/HCPC/Diagnosis code such as effective dates, messages used, parameter limitations.
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.
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.
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.
Medical Office Associate - Per Diem, Days, AMG Multispecialty - Multiple Locations Atlantic Health System IncMedical Office Associate - Per Diem, Days, AMG Multispecialty - Multiple LocationsSummit, NJAtlantic Medical Group is a physician-led and physician-governed organization that delivers the highest quality health care, at the right place, the right price, and the right time. We are a multispecialty physician group with more than 1,000 doctors, nurse practitioners and physician assistants at over 300 locations throughout northern and central New Jersey and northeast Pennsylvania.
Medical Office Associate I, Per Diem, Days - AMG Neuroscience - Summit Atlantic Health System IncMedical Office Associate I, Per Diem, Days - AMG Neuroscience - SummitSummit, NJAtlantic Medical Group is a physician-led and physician-governed organization that delivers the highest quality health care, at the right place, the right price, and the right time. We are a multispecialty physician group with more than 1,000 doctors, nurse practitioners and physician assistants at over 300 locations throughout northern and central New Jersey and northeast Pennsylvania.
NewMedical Office Associate I, Per Diem, Days, 9am-5pm, Radiology and CSHC, Manalapan, NJ Atlantic Health System IncMedical Office Associate I, Per Diem, Days, 9am-5pm, Radiology and CSHC, Manalapan, NJManalapan, NJAtlantic Medical Group is a physician-led and physician-governed organization that delivers the highest quality health care, at the right place, the right price, and the right time. We are a multispecialty physician group with more than 1,000 doctors, nurse practitioners and physician assistants at over 300 locations throughout northern and central New Jersey and northeast Pennsylvania.
Data Manager Maimonides Medical CenterData ManagerBrooklyn, New York$70,000–$85,000 / yearFull timeThe system is anchored by Maimonides Medical Center, one of the nation’s largest independent teaching hospitals and home to centers of excellence in numerous specialties; Maimonides Midwood Community Hospital (formerly New York Community Hospital), a 130-bed adult medical-surgical hospital; and Maimonides Children's Hospital, Brooklyn's only children's hospital and only pediatric trauma center. Prepares actionable analyses and reports to support managed care and value-based contracting, including trend analyses (volume, spend, unit cost, case mix, LOS), cost and utilization analyses, and benchmark comparisons; prepare reports using SQL server, Microsoft Access; assists in proposal development and contract renewals.
Medical Office Associate I, Full Time, Days - AMG Vascular - Freehold and Old Bridge Atlantic Health SystemMedical Office Associate I, Full Time, Days - AMG Vascular - Freehold and Old BridgeFreehold, NJResponsible for providing day-to-day support operations by performing administrative tasks and ensuring high-quality customer service to patients. Medical office associate manages both the front and back of the office, including billing support, scheduling, coding, patient communication, and filing.
Medical Office Associate I, Full Time, Days - AMG Primary Care - Monroe Atlantic Health SystemMedical Office Associate I, Full Time, Days - AMG Primary Care - MonroeMonroe, NJAtlantic Medical Group is a physician-led and physician-governed organization that delivers the highest quality health care, at the right place, the right price, and the right time. We are a multispecialty physician group with more than 1,000 doctors, nurse practitioners and physician assistants at over 300 locations throughout northern and central New Jersey and northeast Pennsylvania.
Assistant Director (FGP), Revenue Optimization & Analytics - Radiology, Manhattan New York University School of MedicineAssistant Director (FGP), Revenue Optimization & Analytics - Radiology, ManhattanNew York, NY$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.
Call Center Service Associate Integrated Resources, IncCall Center Service AssociateNewark, New JerseyContractorThis is Direct Hire with our ClientJob DescriptionSkills Required:3+ years in a large call center with excellent customer service skillsBilingual in Spanish/English is a major plusSome experience in a call center or customer service role within the health insurance industry required. Initiate investigation process based on the nature of the inquiry (claim, member information, benefits, enrollment, appeals, etc.).Utilize available resources to quickly and efficiently resolve or redirect inquiries in accordance with prescribed departmental process.
eService Call Center Asscociate Integrated Resources, InceService Call Center AsscociateNewark, New JerseyContractorThis is Direct Hire with our ClientJob DescriptionSkills Required:3+ years in a large call center with excellent customer service skillsBilingual in Spanish/English is a major plusSome experience in a call center or customer service role within the health insurance industry required. Core Individual Contributor Competencies: Personal and professional attributes critical to successful performance for IndividualContributors: Customer Focus, Accountable, Learn, CommunicateQualificationsEducation/Experience:High school degree or equivalent required.
Medical Office Assistant/Medical Biller EXPRESS IT OF TOMS RIVER LLCMedical Office Assistant/Medical BillerHazlet, NJPart timeJoin EXPRESS IT OF TOMS RIVER LLC as a Medical Office Assistant/Medical Biller in Hazlet, NJ, where you will play a crucial role in supporting our healthcare team. Our commitment to providing quality healthcare services is matched by our focus on creating a supportive and rewarding work environment for our employees.
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.
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.
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, BergenNew Bridge Medical Center is looking for a Medical Assistant Practice Lead.
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.
Audit Coordinator II (Repricing), Healthcare ExlService Holdings IncAudit Coordinator II (Repricing), HealthcareNYRemote$21.63–$26.44 / hourJoin our growing team as an Audit Coordinator II - Repricing, where you'll play a critical role in ensuring accurate claim payments, maximizing savings, and supporting top-tier healthcare clients. EXL harnesses the power of data, analytics, AI, and deep industry knowledge to transform operations for the world's leading corporations in industries including insurance, healthcare, banking and financial services, media and retail, among others.
Documentation Review Nurse Hunterdon HealthDocumentation Review NurseFlemington, NJAssess emergency department documentation using Emergency Department E/M and Critical Care Facility Charge Assessment tool to ensure the patient documentation accurately reflects the patients clinical presentation, diagnoses, and captures all treatment and services provided. Utilize effective critical thinking skills to resolve issues and assess and implement improved methods for efficient capture of patient services in compliance with coding and documentation regulations to ensure revenue capture and reduce denials and appeals.
Remote Certified Professional Coder/ PIP Adjuster CirrusLabsRemote Certified Professional Coder/ PIP AdjusterHamilton, NJRemoteInterpret medical documentation ensure accuracy of billed services IE: CPT, HCPCs codes . Qualifications and Experience: 3-5 years experience conducting code reviews; specifically NJ / NY PIP fee schedules.
Field Reimbursement Manager-Ophthalmology - Minnesota, Wisconsin Regeneron Pharmaceuticals IncField Reimbursement Manager-Ophthalmology - Minnesota, WisconsinNY$165,600–$209,600 / yearProactively educate accounts on support services to ensure patient access to care and work with leadership to monitor and track the impact of support services and its interaction/services offered to providers. Familiarity with health insurance claim forms including UB-04, CMS-1500, explanation of benefits, and prior authorization forms, and super bills charge tickets to troubleshoot cases where billing, claims submission or documentation errors may occur.
Training Manager ExlService Holdings IncTraining ManagerNYRemote$100,000–$120,000 / yearEXL never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process and has not authorized any agencies or partners to collect any fee or payment from prospective candidates. The ideal candidate will bring strong people leadership capability, a proven ability to develop high-performing teams, and experience driving training strategy, operational execution, and learner outcomes.
Outpatient Auditor III ExlService Holdings IncOutpatient Auditor IIINYRemote$70,000–$90,000 / yearAs a Remote Certified Outpatient Facility Auditor, you will apply your in‑depth knowledge of CPT/HCPCS coding, APC payment methodologies, and outpatient regulatory guidelines to audit UB‑04 facility claims only, ensuring accurate APC assignment, proper packaging, and compliant facility billing. Conduct audits across infusion therapy, outpatient surgeries, imaging, and interventional radiology, such as: Verifying correct APC assignment for chemotherapy and non-chemotherapy infusions, hydration services, and observation-related services.
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.