NewPrior Authorization Specialist GeneDX LLCPrior Authorization SpecialistNJRemote$29.56–$33.80 / hourGeneDx is at the forefront of transforming healthcare through its industry-leading exome and genome testing and interpretation services, fueled by the world's largest, rare disease data sets. We provide competitive compensation and benefits that reflect local market practices and legal requirements in each country where we operate, helping employees thrive both professionally and personally.
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).
Registered Nurse (RN) - Home Visits Help at Home LLCRegistered Nurse (RN) - Home VisitsForest Hills, NYOverview\n \nAs the nation's leading provider of high-quality home care services, we empower our clients to live independently, safely, and with dignity in their own homes. One year of nursing experience.\n \nThe above statements are intended to describe the general nature and level of work being performed by people assigned to this classification.
Clinical Documentation Integrity Specialist - Remote Med-Metrix, LLCClinical Documentation Integrity Specialist - RemoteParsippany-Troy Hills, NJRemoteThe Clinical Documentation Integrity Specialist performs concurrent chart reviews to validate that the clinical documentation in the medical record appropriately describes the patient's severity of illness, complexity of care, and risk of mortality to facilitate appropriate coding. Physical 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.
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.
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.
Clinical Documentation Integrity Specialist St. John's Episcopal HospitalClinical Documentation Integrity SpecialistFar Rockaway, NYAdditionally, 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.
Outpatient Audit Specialist PRN - Remote Datavant LLCOutpatient Audit Specialist PRN - RemoteNYRemote$35–$45 / hourWhat We're Looking For: As an Outpatient Auditing Specialist, you will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, and coding workflow operations reviews. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies.
Medical Records Coder II, Full Time, Family Medicine, Summit Atlantic Health System IncMedical Records Coder II, Full Time, Family Medicine, SummitSummit, NJAtlantic Medical Group is a physician-led and physician-governed organization that delivers the highest quality health care, at the right place, the right price, and the right time. We are a multispecialty physician group with more than 1,000 doctors, nurse practitioners and physician assistants at over 300 locations throughout northern and central New Jersey and northeast Pennsylvania.
Facility-Fee Emergency Department Medical Coder Sutherland GlobalFacility-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 Consultant, Revenue Cycle and Financial Operations | Healthcare Business Transformation FTI Consulting IncSenior Consultant, Revenue Cycle and Financial Operations | Healthcare Business TransformationNew York, NYThe Senior Consultant in Revenue Cycle and Financial Operations within our Healthcare Business Transformation practice plays a key leadership role advising physician groups, health systems, private equity and technology companies on strategies to optimize financial performance and operating effectiveness across the revenue cycle. This role supports complex client engagements from assessment through implementation, partners directly with client executives to align initiatives to enterprise priorities, and delivers measurable outcomes related to cost optimization, revenue enhancement, technology implementation and financial operations.
NewMgr Multi Facility CDI SMNJ Medical Records FAC#1 Prime Healthcare Services IncMgr Multi Facility CDI SMNJ Medical Records FAC#1Newark, NJCombining state-of-the-art technology, the latest diagnostic and therapeutic procedures, leading-edge research, and a network of highly qualified physicians, nurses, and allied health professionals, the hospital provides top-quality health care services delivered with compassionate care. Established by the Franciscan Sisters of the Poor in 1867, Saint Michael''s Medical Center is a 358-bed regional tertiary-care, teaching, and research center in the heart of Newark''s business and educational district and is accredited by The Joint Commission.
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.
DRG Reviewer MachinifyDRG ReviewerNY$90,000–$115,000 / yearAs part of the Complex Payment Solutions Team, you will, as a DRG Reviewer, be a key contributor responsible for conducting thorough DRG payment validation reviews, including clinical and coding assessments, of medical records and related documentation in accordance with contract-specific review criteria. Qualifications: Inpatient claims auditing, quality assurance or recovery auditing experience of 2 years or more required, and/or Inpatient Clinical Documentation Integrity experience of 2 years or more required.
DRG QA and Trainer MachinifyDRG QA and TrainerNY$85,000–$95,000 / yearThis position plays a key role in auditing the work of both new hires and current staff while conducting training to ensure team members are equipped with the knowledge and skills needed to succeed. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise.
Dentist ( Pediatric Experience Required) - Exams Only - Queens PDS Management Services, LLCDentist ( Pediatric Experience Required) - Exams Only - QueensQueens, NY$4,000–$10,000 / hourPart timeWe offer a comprehensive range of services, including:Pediatric DentistryOrthodonticsLaser SurgeryConscious SedationOutpatient CareWe also provide specialized training programs to help you enhance your expertise and grow your career within our innovative organization. PDS Management Services is seeking skilled Pediatric Dentists or General Dentists with Pediatric Experience to provide exceptional oral healthcare to children at our Queens, NY location.
NewMgr - Multi-Facility CDI - SCDNNJ Medical Records Fac#01 St. Clare's - DenvilleMgr - Multi-Facility CDI - SCDNNJ Medical Records Fac#01Denville, New JerseyFull timeSaint Clare's Health includes CMS 5-Star Rated hospitals and is an award-winning provider of safe, high quality, compassionate care, serving the communities of Morris, Warren and Sussex counties. The Multi-Facility CDI Manager will work closely with the Chief Financial Officer and Director of HIM at the individual facility to be instrumental in supplementing assistance to these departmental functions pertaining to clinical documentation and inpatient coding.
Configuration and Quality Audit Analyst | Hybrid NY HealthfirstConfiguration and Quality Audit Analyst | Hybrid NYNew York, NY$68,900–$99,620 / yearAt least three years of experience in a managed care organization, commercial health plan, government program, third-party administrator, or other healthcare operations environment performing claims analysis, configuration audit, provider reimbursement, payment integrity, or healthcare data analysis. Candidate must display effective communication skills and have detailed skillset to configure Office365, effectively communicate product updates, interface with the vendor on potential issues, and ensure platform governance rules are followed.
Medical Coder - Inpatient (DRG Reviewer) Acentra HealthMedical Coder - Inpatient (DRG Reviewer)NY$29.19–$36 / hourMinimum of 2 years of progressive hands-on experience in acute care inpatient coding, clinical documentation improvement (CDI), medical scribing, DRG auditing/review, or related healthcare documentation experience. In fact, you have all you need to take charge of your career and accelerate better outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.
Vice President, Quantitative Sciences & Development SK Life Science, Inc.Vice President, Quantitative Sciences & DevelopmentParamus, New Jersey$325,000–$375,000 / yearFull timeOverview: The Vice President, Quantitative Sciences & Developmentprovides strategic, scientific, and operational leadership for the company's Clinical Pharmacology, Pharmacometrics, Toxicology, DMPK, Biostatistics, Statistical Programming, and Clinical Data Management functions across all phases of drug development. This executive is responsible for developing and overseeing execution of integrated quantitative strategies that support efficient translation from non-clinical development, clinical development, regulatory submissions, and evidence generation while ensuring delivery of high-quality, inspection-ready clinical data and statistical analyses.