Associate, Payment Integrity IBR Oscar HealthAssociate, Payment Integrity IBRNew York, New York$91,908–$120,629 / yearThis is accomplished by leveraging a deep understanding of Oscar's claim infrastructure, workflows, workflow tooling, platform logic, data models, etc., to work cross-functionally to understand and translate friction from stakeholders into actionable opportunities for improvement. Proactively identify and document potential billing errors, including duplicate billing of items, services, or procedures as improper unbundling of services (e.g., separating components that should be billed together) and charges for non-covered or non-rendered services.
Revenue Cycle Billing Specialist - Per Diem - Day - MSO/Centralized Billing Lawrenceville NJ Capital HealthRevenue Cycle Billing Specialist - Per Diem - Day - MSO/Centralized Billing Lawrenceville NJLawrenceville, NJ$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).
Senior Consultant - Clinical Documentation Specialist DeloitteSenior Consultant - Clinical Documentation SpecialistNew York, NY$95,600–$188,400 / 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.
Senior Consultant - Clinical Documentation Specialist Deloitte Touche Tohmatsu LtdSenior Consultant - Clinical Documentation SpecialistNew York, NY$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.
Certified Professional Coder, Special Investigations Unit (Aetna SIU) CVS Health CorpCertified Professional Coder, Special Investigations Unit (Aetna SIU)NY$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.
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.
NewClaim Benefit Specialist CVS Health CorpClaim Benefit SpecialistNJ$17–$28.46 / hourAnalyzes claims data and generate reports to identify trends, patterns, or areas for improvement to help inform process enhancements, policy changes, or training needs within the claims processing department. Performs claim documentation review, verifies policy coverage, assesses claim validity, communicates with healthcare providers and policyholders, and ensures accurate and timely claims processing.
Medical Biller Javier Zelaya MD PCMedical BillerBrooklyn, New York$18–$22 / hourThe 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.
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.
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.
Senior Software Engineer Throtle, Inc.Senior Software EngineerRed Bank, NJYou will contribute across the full stack, working with modern front-end frameworks, robust backend services, cloud-native AWS infrastructure, and relational databases. This is an excellent opportunity for an experienced engineer who thrives in an agile environment, enjoys solving complex technical challenges, and is passionate about mentoring peers and contributing to architectural decisions.
Medical Office Manager-Bronx The Dermatology SpecialistsMedical Office Manager-BronxNew York City2 years’ + experience in Hospitality or Medical management as a minimum; Experience in managing a team; Ability to give direction with confidence; Hard-working and willing to be part of a team; Desire to grow with the practice; Flexible availability. - Knowledge of health insurance policies, guidelines- including copays, coinsurances, referrals, verification of insurances; handling patients' records discretely, updating demographic and financial information; Protecting and securing medical records.
Medical Office Manager - Brooklyn/ Manhattan The Dermatology SpecialistsMedical Office Manager - Brooklyn/ ManhattanBrooklyn, New York2 years’ + experience in Hospitality or Medical management as a minimum; Experience in managing a team; Ability to give direction with confidence; Hard-working and willing to be part of a team; Desire to grow with the practice; Flexible availability; and. Knowledge of health insurance policies, guidelines- including copays, coinsurances, referrals, verification of insurances; handling patients' records discretely, updating demographic and financial information; Protecting and securing medical records.
Charge Entry and Eligibility Specialist The Cardiovascular Care GroupCharge Entry and Eligibility SpecialistSpringfield, NJThe Charge Entry and Eligibility Specialist supports The Cardiovascular Care Group's commitment to delivering exceptional vascular care by ensuring accurate billing, efficient revenue cycle operations, and a positive patient financial experience. The ideal candidate demonstrates strong attention to detail, knowledge of medical billing processes, excellent customer service skills, and the ability to work effectively in a fast-paced healthcare environment.
CPC Investigator Blue Cross and Blue Shield AssociationCPC InvestigatorNewark, NJ$70,500–$94,395 / yearThe 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. The incumbent will also be responsible for handling low level investigative activities (external) related to claims, enrollment, accounting, receive and review suspected fraud and to complete cases with all information and analysis for resolution, as the manager and prior approved guidelines may direct.
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.
NewField Reimbursement Manager, Greensboro NC - Dermatology Johnson & JohnsonField Reimbursement Manager, Greensboro NC - DermatologyTitusville, NJRequired Skills: Preferred Skills: Account 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.
Research Scientist R37 Lab, R1 RCMResearch ScientistNew 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. The Company’s employment practices, including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law.
Coder - Physician Practice - CPC Required Virtua Health IncCoder - Physician Practice - CPC RequiredMount Laurel, NJRemote$26–$39.11 / hourWe assembled more than 14,000 colleagues, including over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques to provide exceptional care close to home. That means bringing life-changing resources and health services directly into our communities through our Eat Well food access program, telehealth, home health, rehabilitation, mobile screenings, paramedic programs, and convenient online scheduling.