Research Billing Specialist Hackensack University Medical CenterResearch Billing SpecialistHackensack, NJA day in the life of a Research Billing Specialist at Hackensack Meridian Health includes: Invoices and track payments from clinical trial sponsors for patient visits and other study related costs as outlined in the clinical trial budgets and contracts. Education, Knowledge, Skills and Abilities Required: Bachelor`s Degree in Accounting, Sciences or equivalent experience and High School diploma, general equivalency diploma (GED), GED equivalent programs, and/or other Vocational degrees/certificates.
Payment Integrity Concept Development SME ExlService Holdings IncPayment Integrity Concept Development SMENY$75,100–$107,300 / yearThe ideal candidate has a proven history of successfully developing new payment integrity concepts from initial idea through implementation, resulting in significant financial recoveries while maintaining high clinical accuracy and low provider abrasion. The Subject Matter Expert (SME) - Payment Integrity Concept Development is responsible for designing, developing, and validating innovative payment integrity concepts that identify inaccurate, inappropriate, or unsupported healthcare claims.
Revenue Cycle Specialist-Revenue Integrity Pathology-REMOTE Weill Cornell Medical CollegeRevenue Cycle Specialist-Revenue Integrity Pathology-REMOTENew York, NYRemote$32.69–$36.76 / hourThe CBO partners with WCM Clinical Departments to increase and expedite service revenue, reduce aged AR, and trend denials for their root causes thereby driving efficiencies, to include clinical documentation improvement and coding denials prevention. Resolves outstanding accounts utilizing ancillary applications and websites as tools to retrieve medical documentation, claim status and billing guidelines to substantiate corrected claim submissions, written appeals, coding and medical necessity reviews.
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.
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 Navigator HealogicsPatient NavigatorNorth Bergen, New JerseyLearn more about this role here: Healogics is the largest provider of advanced wound care services in the United States, treating more than 300,000 chronic wound patients annually across over 600 sites. All Healogics employees must perform their job responsibilities according to all Healogics policies, Hospital policies, as well as to accrediting organizations, federal and state regulation, and to the Centers for Medicare and Medicaid Services (CMS) guidelines, as applicable.
EPIC Physician Billing Analyst KLM CareersEPIC Physician Billing AnalystHicksville, New York3. Do you have 3+ years of experience and expertise in Epic's Professional Billing module, including charge router, work queue configuration, collection agency workflows, statement processing, benefit engine, and estimates. Expertise in Epic's Professional Billing module, including charge router, workqueue configuration, collection agency workflows, statement processing, benefit engine, and estimates.
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.
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.
Quality Analyst - Clinical Validation Audit ExlService Holdings IncQuality Analyst - Clinical Validation AuditNYRemote$85,000–$100,000 / yearResponsible for reviewing the accuracy and consistency of clinical DRG auditing auditors to ensure audits are appropriately marked for findings and no findings. For positions based in higher-cost zones (e.g., California, New York, New Jersey), actual compensation may exceed the posted range; your recruiter will share specifics during the process.
Certified Professional Coder, Special Investigations Unit (Aetna SIU) CVS Health CorpCertified Professional Coder, Special Investigations Unit (Aetna SIU)NY$43,888–$102,081 / yearThe Certified Professional Coder (CPC) will perform medical claim reviews to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do.
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 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.
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.
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.
Medical Billing Specialist - Denials Sonic Healthcare USAMedical Billing Specialist - DenialsHicksville, NY$18–$24 / hourUse established protocols to contact providers and clients to resolve discrepancies in processed, partially paid and unpaid claims with timely appropriate follow up action. We offer Medical, Vision and Dental Insurance | Short Term and Long-Term disability | Voluntary term life | 401-K plus match | Paid Time Off| Paid holidays.
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 Documentation Integrity Specialist Episcopal Health ServicesClinical Documentation Integrity SpecialistFar Rockaway, New YorkAdditionally, St. John's is proud to be redesignated as a Baby-Friendly® Hospital by Baby-Friendly USA – the accrediting body and national authority for the Baby-Friendly Hospital Initiative (BFHI) in the United States. The hospital is a recipient of the Gold-Plus Get with the Guidelines®-Stroke Quality Achievement Award and the Gold-Plus Get with the Guidelines®-Heart Failure Quality Achievement Award from the American Heart Association.
Facility-Fee Emergency Department Medical Coder Sutherland Global Services IncFacility-Fee Emergency Department Medical CoderClifton, NJThe Facility-Fee Emergency Department Medical Coder is responsible for the accurate review, abstraction, and assignment of ICD-10-CM, CPT, HCPCS, facility-specific charging methodologies, and applicable modifiers for Emergency Department (ED) facility encounters. The coder will review clinical documentation, emergency department records, physician documentation, nursing notes, ancillary reports, and charging information to accurately capture facility services rendered during emergency department visits.
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.