Senior Consultant - Clinical Documentation Specialist DeloitteSenior Consultant - Clinical Documentation SpecialistMorristown, NJ$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.
Medical Coder Surgical Care Affiliates LLCMedical CoderNYAs part of Optum, SCA Health is redefining specialty care by developing more accessible, patient-centered practice solutions for a network of more than 370 ambulatory surgical centers, over 400 specialty physician practice clinics and numerous labs and surgical hospitals. Beacon Orthopaedics & Sports Medicine is a nationally known and respected leader in providing sports medicine and orthopedic care for over twenty five years with 20+ locations in Southwest Ohio (Cincinnati and Dayton), Northern Kentucky and Southeastern Indiana.
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 SpecialistClifton, 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.
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.
Analyst, Compliance Columbia UniversityAnalyst, ComplianceNew York, NY$80,000–$90,000 / yearProvide oversight and perform, as needed, ongoing, risk-based, and ad hoc coding auditing of complex services, across multiple specialties, rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare/Medicaid, medical necessity, and NCD/LCD requirements; including but not limited to retrospective audits for established providers and prospective audits for newly onboarded providers to ensure appropriate documentation, coding accuracy, and billing compliance. Support departmental compliance teams by providing advisory guidance and expert knowledge of CPT/HCPCS and ICD-10 guidelines across multiple specialties, as well as teaching facility guidance, professional fee billing, including global surgical package rules, modifier usage, incident-to services, split/shared services, and emerging regulatory changes.
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.
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.
Medical Assistant - Urology UnitedHealth Group IncMedical Assistant - UrologyLake Success, NYClinical › Corporate and business operations › Customer and support services › Early careers› Sales and account management › Technology and data› Physicians› Advanced practice clinicians› Pharmacy› Behavioral health› Nursing› Medical coding› Clinical support› U.S. › Ireland & UK › India › Philippines › Culture of Belonging› Employee Benefits› Blog. Technology and data Artificial intelligence Architecture Business systems analysis Data analytics Data engineering Data science Network infrastructure Product management & development Security and risk Software engineering.
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).
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.
Billing Manager DocGo IncBilling ManagerNY$75,000–$85,000 / yearDocGo's proprietary, AI-powered technology, logistics network, and dedicated field staff of over 5,000 certified health professionals elevate the quality of patient care and drive efficiencies for municipalities, hospital networks, and health insurance providers. About DocGo: DocGo is leading the proactive healthcare revolution with an innovative care delivery platform that includes mobile health services, population health, remote patient monitoring, and ambulance services.
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.
RCM Customer Service Specialist The Dermatology SpecialistsRCM Customer Service SpecialistLong IslandThe role handles inquiries via phone, email, and EMR-tasked billing requests, assists patients with billing questions, and ensures accurate interpretation of Explanation of Benefits (EOBs), payment postings, and claim denials. The CSR collaborates with the Revenue Cycle team and Ops team to support timely resolution, maintain high patient satisfaction, and improve financial outcomes for the dermatology practice.
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).
Director, Payment Integrity Capital Rx, Inc.Director, Payment IntegrityNew York, NY$206,400–$258,000 / yearPosition Summary: The Director, Payment Integrity will build and lead Judi Health's payment integrity program from inception, establishing the infrastructure, processes, and team that will ensure claims are paid correctly, compliantly, and efficiently across our commercial plan population. By delivering true price transparency, eliminating unnecessary middleman fees, and leveraging advanced AI-powered care delivery, Judi Health helps clients achieve unprecedented operational efficiency and service levels.