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.
Director, Transformation Services - Revenue Integrity Med-Metrix, LLCDirector, Transformation Services - Revenue IntegrityParsippany-Troy Hills, 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. Project leadership and workplan management experience for opportunity assessments within a consulting firm setting with a focus on middle revenue cycle areas (clinical documentation, revenue integrity, charging, coding).
Revenue Cycle Supervisor (Self Pay and Specialty) Columbia UniversityRevenue Cycle Supervisor (Self Pay and Specialty)Fort Lee, NJ$66,300–$78,000 / yearDemonstrated skills in A/R management, Customer Service, problem assessment, and resolution, and collaborative problem-solving in complex and interdisciplinary settings, including strong proficiency in healthcare and payer guidelines as it pertains to billing and reimbursement. The Revenue Cycle Supervisor (Self Pay and Specialty) will also be responsible for day-to-day operations of the payment posting process, the International Business Line, Specialty billing, and the oversight of guarantor work queues.
Sr. Call Center Service Assoc Blue Cross and Blue Shield AssociationSr. Call Center Service AssocHopewell, NJ$52,787–$70,172 / yearThis 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. Responsibilities: Receive escalated customer inquiries and provide second level resolution by initiating or continuing investigation process, utilizing available resources and accurately documenting customer inquiry and actions taken in accordance with departmental quality guidelines.
Call Center Service Associate Blue Cross and Blue Shield AssociationCall Center Service AssociateHopewell, NJ$47,961–$63,820 / yearThis 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.
Professional Coder I Iconma LLCProfessional Coder INewark, NJRequirements: 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). Support the collection and distribution of documentation and coding improvement tools for designated practice units as applicable.
Certified Medical Assistant (CMA) – Regional Drug Dependency Unit Akicita FederalCertified Medical Assistant (CMA) – Regional Drug Dependency UnitKearny, NebraskaThis role is responsible for assisting with patient care activities, performing routine clinical tasks, managing patient records, and supporting the overall operation of the unit, ensuring compassionate, culturally sensitive care for individuals undergoing substance abuse treatment. $50,000 - $65,000 a year Position Summary The Certified Medical Assistant (CMA) will provide clinical and administrative support to the healthcare team in the Regional Drug Dependency Unit (RDDU) at the Great Plains Area facility in Winnebago, NE.
Senior Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpSenior Investigator, Special Investigations Unit (Aetna SIU)NY$46,988–$112,200 / yearThis position will routinely handle high profile or highly sensitive matters involving cases that are national in scope, as well as, complex cases involving multi-lines of business, multiple subjects, or intricate healthcare fraud schemes. Strong communication skills, both written and oral, are necessary for the development and implementation of professional presentations for internal and external stakeholders regarding healthcare fraud matters and Enterprise approach to FWA.
SIU Investigator Centene Corporation GroupSIU InvestigatorNJ$56,200–$101,000 / yearCollaborates with internal business partners, compliance, legal, provider and payment integrity teams, and external agencies to coordinate investigative activities, support corrective actions, recoveries, and case resolution efforts. 2+ years Fraud, waste, and abuse investigations, healthcare investigations, claims audits, payment integrity, healthcare compliance, law enforcement investigations, or a related investigative field required.
Special Investigation Unit Investigator Centene Corporation GroupSpecial Investigation Unit InvestigatorNJ$56,200–$101,000 / yearEducation/Experience: Bachelor's Degree Business, Criminal Justice, Healthcare Administration, Public Health, or a related field; or equivalent experience (or) An Associates or Bachelor's degree in criminal justice or a related field; (or) employment as an investigator in the MMCO's SIU on or before the effective date of this SubPart required. Minimum of five (5) years in healthcare field working in fraud, waste and abuse investigations and audits, (or) five years of insurance claims investigation experience or professional investigation experience with law enforcement agencies, (or) seven years of professional investigation experience involving economic or insurance related matters.
Case Manager Research Foundation of The City University of New YorkCase ManagerBrooklyn, New YorkThese functions include legal assessment and signing of agreements where RFCUNY is named as a fiscal agent; setting up award accounts; preparing sub-awards and assisting PIs in monitoring the work of the recipients of sub-awards; supporting project directors with hiring and managing research project and sponsored program staff; supporting the purchasing and paying for goods and services with grant and program funds; managing financial aspects of projects including accounts receivable, financial reporting, invoicing, budget monitoring, and cost compliance with uniform guidance; ensuring that sponsor financial requirements are met; monitoring compliance with applicable project and financial management rules and laws; supporting the management of independent and external audits and financial reviews; and providing data, information, management expertise, and other supports to CUNY’s research and sponsored programs. RFCUNY’s services allow CUNY researchers, faculty, and staff to focus on their intellectual curiosity and scientific discoveries, on projects and programs that serve our local and global communities, proposing concrete solutions to society’s most pressing challenges.
Pharmacy Care Technician - Work From Home (Fairfield, NJ) CVS Health CorpPharmacy Care Technician - Work From Home (Fairfield, NJ)NJ$17–$31.30 / hourPharmacy Care Technicians assist with inbound phone calls; interact with customers and cross functional team to answer questions, solve problems, provide education, and maintain our company's reputation for high-quality service. In this role, you will assist in accurately reading, interpreting and entering prescriptions into the computer system including calculation of doses and assignment of directions and accepting proper insurance payment in a timely fashion.
Assistant Director (FGP), Revenue Optimization & Analytics - Radiology, Manhattan NYU Langone HealthAssistant Director (FGP), Revenue Optimization & Analytics - Radiology, ManhattanNew York, NY$121,792.22–$210,091.64Full timeWork 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.
Principal Engineer-Software Development Verizon Communications IncPrincipal Engineer-Software DevelopmentBasking Ridge, NJ$120,500–$231,000 / yearYou will mentor technical teams and develop high-quality, robust applications that meet critical business needs within our evolving Customer Experience Platform (CXP) and FiOS Order management platform. In the role of Principal Engineer of Software Development, you will provide technical leadership for the design and implementation of complex, scalable software solutions primarily using Java Spring Boot and React.
Director, Patient Access & Revenue Cycle RWJ Barnabas Health Medical IncDirector, Patient Access & Revenue CycleNewark, NJ$133,924–$189,167 / yearAchieve goal of reducing bill hold days below target by leading revenue cycle committee meetings with members of finance, clinical departments, coding, and revenue integrity. Job Overview: The Director of Patient Access and Revenue Cycle Services is responsible for the comprehensive leadership, management, and strategic direction of all hospital patient access/revenue cycle operations.
Engagement Manager, Revenue Cycle Chartis Group LLCEngagement Manager, Revenue CycleNYRemote$137,000–$180,000 / yearEngagement Managers lead work across a portfolio of client engagements, structuring workplans, managing teams, and partnering directly with client stakeholders to turn insights into practical, sustainable improvements across the revenue cycle. The salary range for this role takes into account the wide range of factors that are considered in making compensation decisions including, but not limited to, skills, experience, training, licensure and certifications, practice area, and other business and organizational needs.
Director, Compliance Columbia UniversityDirector, ComplianceNew York, NY$150,000–$160,000 / yearThe Director contributes to the success of CUIMC's mission provides strategic direction and operational leadership for a team of compliance professionals, supports provider education and dispute resolution, and partners closely with Revenue Cycle, Clinical Departments, Legal, and Leadership to mitigate risk and promote compliant billing practices across a large academic medical center. Expert knowledge of the General Compliance Program Guidance issued by the HHS OIG and the DOJ's Evaluation of Corporate Compliance Programs, as well as fraud, waste, and abuse laws (Stark Law, Anti-Kickback Statute, False Claims Act).
Senior Compliance Auditor Montefiore Medical CenterSenior Compliance AuditorBronx, NY$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).
NewClaims Specialist- Liab Crawford & CoClaims Specialist- LiabBerkeley Heights, NJTo determine the actual offer, Crawford considers a wide range of factors including the candidate's previous experience and education, market rates, minimum pay requirements for the applicable jurisdiction, business segment, supply/demand, and scheduled hours. Verifies policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves within designed authority, as necessary, during the processing of the claim.
Care Manager (Clinical) [CMA] Guideway Care, Inc.Care Manager (Clinical) [CMA]NYUsing computer applications Making and answering phone calls the majority of the shift Welcoming patients Reviewing patient medical records Coding and filling out insurance forms Scheduling appointments Arranging for hospital admissions and laboratory services Handling correspondence, billing, and bookkeeping Escalating patient concerns or needs to appropriate provider. Essential Functions: (may include, but not limited to): Manage and support patients' healthcare needs via telephonic outreach Conduct and document visits by using several technology platforms and EHRs Monitors adherence to care plans, evaluates effectiveness, monitors patient progress in a timely manner, and facilitates changes as needed.