Health Information Coder Inpatient Hunterdon HealthHealth Information Coder InpatientFlemington, NJWhen determining an applicants hourly rate and/or base salary, several factors may be considered as applicable (e.g., years of relevant experience, education, internal equity, and specialty). Benefitofferings vary based on status and may include but not be limited to medical, dental, vision, family forming, paid time off, tuition reimbursement, and retirement savings.
Senior Analyst, Payment Integrity Oscar Health IncSenior Analyst, Payment IntegrityNew York, NYRemote$64,832–$85,092 / 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. Work Location: This is a remote position, open to candidates who reside in: Atlanta, Georgia; Chicago, Illinois; Dallas, Texas; Louisville, Kentucky; Minneapolis, Minnesota; Philadelphia, Pennsylvania; Salt Lake City, Utah.
Director, Payment Integrity Capital Rx LLCDirector, 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.
Lead Software Engineer Humana IncLead Software EngineerNew York, NYRemote$155,200–$213,400 / yearWork at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Exercise independent judgment and decision making on complex issues regarding job responsibilities and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action.
Marketing Director, Biomarkers / Director of Marketing, Molecular Diagnostics Jacobs Management GroupMarketing Director, Biomarkers / Director of Marketing, Molecular DiagnosticsPrinceton, NJA growing uro-oncology diagnostics company is seeking a Marketing Director to lead strategy for a newly acquired biomarker portfolio: physician adoption, market access, and launch, built from scratch. 8-12 years commercial marketing experience in molecular diagnostics, medical devices, pharma, or precision medicine, including field sales.
Co-Founder & CEO - AI Clinical Documentation Compliance FutureSightCo-Founder & CEO - AI Clinical Documentation ComplianceNew York, NY$80–$85 / hourYou’ll co-create with a proven studio team, led by John Carbrey (4x entrepreneur, $100M ARR), Krista LaRiviere (3x exited, E&Y Top Women Entrepreneur), Alan Smith (Strategyzer co-founder, $120M in products built), Prathna Ramesh (former MD of Maple Leaf Angels, $275M in follow-on capital), and Johnny Tong (0-to-1 builder, acquired by SAP and Stripe) bring a rare combination of operator exits, institutional investing, and AI product depth. The market signal is incredibly strong: Unprompted Product Pull: Every single lead described the exact product we want to build: a pre-billing, real-time, EHR-integrated flagging layer that checks documentation against payer-specific rules before claims are submitted.
Executive Medical Director, Neurology, Clinical Development Karwell TechnologiesExecutive Medical Director, Neurology, Clinical DevelopmentBridgewater, NJThis individual will be the primary point person for medical monitoring and oversight of assigned clinical programs, including monitoring of clinical studies, review and interpretation of clinical trial data, authoring clinical study and regulatory communications and documents, and monitoring of competitor activities and data. Provide medical/clinical expertise to internal (Marketing, Sales, Manufacturing, Market Access, Patient Services, Regulatory Affairs, R&D, and Legal) and external (healthcare professionals, Data Safety Monitoring Boards, patients, advocacy groups, etc.) customers.
Revenue Integrity Expert - Healthcare MercorRevenue Integrity Expert - HealthcareNew York, New YorkRemoteOversee charge capture , charge integrity , and revenue integrity functions to ensure accurate and compliant charge submission. Conduct charge audits to identify missed charges, duplicate charges, and charge capture errors across clinical departments.
Principal, Medical Economics Evergreen Nephrology LLCPrincipal, Medical EconomicsNY$135,000–$150,000 / yearThis role will help ensure the integrity of claims data flowing into enterprise datasets, enable more sophisticated economic and impact modeling, and connect cost insights with clinical and risk stratification efforts to support value-based care performance. Partner with data, actuarial, and analytics teams to validate healthcare claims data structures, ensure data is accurately represented in enterprise datasets, and resolve discrepancies affecting downstream reporting and analysis.
Outpatient Auditor Manager ExlService Holdings IncOutpatient Auditor ManagerNYRemote$105,000–$115,000 / yearThe role directly manages auditors responsible for outpatient payment integrity reviews, including outpatient facility, ambulatory surgery, emergency department, observation, and professional claim audits. The ideal candidate demonstrates strong leadership and analytical skills, along with expertise in CPT, HCPCS, NCCI edits, CMS outpatient reimbursement methodologies, and payer-specific billing requirements.
Remote Certified Professional Coder/ PIP Adjuster EDI StaffingRemote 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.
Customer Support Coach - NORAM Digital Arbitrage IncCustomer Support Coach - NORAMNYRemote$55,000–$77,000 / yearOur Customer Support Team: Join a dynamic, fully remote team of over 60 global Customer Support professionals united by our goal of delivering exceptional customer experiences across live chat, email, and phone. Since our founding in 2012, we''ve become the World''s Best Hotel PMS Solutions Provider and landed on Deloitte''s Technology Fast 500 again in 2024, but we''re just getting started.
NewCall Center Service Associate Horizon Healthcare ServicesCall Center Service AssociateHopewell, New Jersey47,961 - $63,820 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. For over 90 years , we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience.
Procedural Billing Specialist II-MSW-FT Days Mount Sinai Health SystemProcedural Billing Specialist II-MSW-FT DaysNew York, NY$59,895–$89,843 / yearWe are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics, top 5 in Cardiology/Heart Surgery, and top 20 in Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. 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.
Clinical Quality Specialist HealthfirstClinical Quality SpecialistNew York, NY$68,900–$99,620 / yearThe Clinical Quality Specialist is responsible for performing Healthcare Effectiveness Data and Information Set (HEDIS) medical record review, supplemental data validation, data abstraction, and clinical data quality activities using internal and external clinical data sources. The specialist works collaboratively with providers, vendors, and internal departments to ensure compliance with NCQA, CMS, state, and organizational requirements while supporting data integrity and audit readiness.
Certified Professional Coder Apprentice (CPC-A) Acentus Practice Management LLCCertified Professional Coder Apprentice (CPC-A)Mt. Laurel, NJRemoteDaily duties of a CPC-A include resolving charge review edits to ensure accurate coding and billing, researching and clearing claim edits prior to claim submission, and investigating and working coding-related claim denials and payor rejections. In this role, you will play a crucial part in ensuring our professional medical billing and coding processes run smoothly, making a significant impact on our ability to help provide exceptional care to patients.
Behavioral Health Quality Analyst ExlService Holdings IncBehavioral Health Quality AnalystNYRemote$60,100–$98,700 / 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.
Senior Quantitative Scientist, Commercial-Facing Verana Health IncSenior Quantitative Scientist, Commercial-FacingNew York, NYRemote$141,441–$212,161 / yearBuilt on the values of continuous learning, cross-functional collaboration, and rigorous scientific research, the Data & Science team strives to improve patient care by innovating at the intersection of real world data, clinical context, and methodology with our partners to ensure all available data is being used to in the most efficient, data-driven way possible. Verana Health, a digital health company that delivers quality drug lifecycle and medical practice insights from an exclusive real-world data network, recently secured a $150 million Series E led by Johnson & Johnson Innovation - JJDC, Inc. (JJDC) and Novo Growth, the growth-stage investment arm of Novo Holdings.
Clinical Trials Medicare Coverage Analyst VitaliefClinical Trials Medicare Coverage AnalystNew Brunswick, NJRemote$75,000–$100,000 / yearTHE ROLE We are seeking a full-time, fully benefited Vitalief employee to serve as a Clinical Trials Medicare Coverage Analyst in a fully remote capacity, supporting Vitalief’s client, a leading academic clinical research center in the Chicago area. KEY RESPONSIBILITIES Conduct Medicare Coverage Analyses (MCA) for a mixture of oncology and non-oncology clinical trial protocols identifying which procedures and services are billable to Medicare versus those considered research related.
Front Desk Coordinator - Full Time RestorixHealthFront Desk Coordinator - Full TimeRahway, NJResponsible for scheduling patients, precertification, insurance verification, charge entry and daily reconciliations, this position will wear many hats. When you join our team, you have the opportunity to develop your career based on your strengths and potential, including the possibility to move functionally, geographically, laterally and vertically.