Experienced Associate, Forensics BDO USA PCExperienced Associate, ForensicsNY$65,000–$85,000 / yearJob Summary: The Experienced Associate, Healthcare Forensics role is a highly analytical and detail-oriented individual responsible for identifying, analyzing, and resolving payment inaccuracies across healthcare claims as it relates to reimbursement disputes, fraud, waste, and abuse investigation, regulatory compliance, and litigation. Keywords: Forensic, Healthcare Coding, Payment Integrity, Revenue Integrity, Revenue Cycle Management, Consulting, Disputes, Litigation, Investigation, Fraud, Waste, Abuse, Coding Auditor, Charge Capture, Healthcare Compliance.
Inpatient Program Strategy & Execution Manager Cohere Health Technologies LLCInpatient Program Strategy & Execution ManagerNYRemote$110,000–$127,000 / yearBy unifying pre-service authorization data with post-service claims validation, we''re creating a transparent healthcare ecosystem that reduces waste, improves payer-provider collaboration and patient outcomes, and ensures providers are paid promptly and accurately. With an enterprise approach that streamlines payer-provider decision-making across the care continuum-including policy, prior authorization, payment accuracy, and more-the company improves collaboration and reduces burden, resulting in up to 8x ROI and 94% provider satisfaction.
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).
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.
Inpatient DRG Reviewer Zelis Healthcare, Inc.Inpatient DRG ReviewerNJ$79,000–$99,750 / yearWhere the regrouped 'new DRG' differs from what was originally claimed by the provider, write a customer facing 'rationale' or 'findings' statement, highlighting the problems found and justifying the revised choices of new codes and DRG, based on the clinical evidence obtained during the review. This is a place for builders with a growth mindset who act with agility, embrace change, and use modern technology to shape smarter solutions, exceptional experiences, and the future of our industry for our clients, customers, and our culture.
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.
NewField Reimbursement Manager, Greensboro NC - Dermatology 6077-Johnson & Johnson HCS Legal EntityField Reimbursement Manager, Greensboro NC - DermatologyTitusville, New JerseyAccount Management, Coaching, Competitive Landscape Analysis, Compliance Management, Consulting, Cross-Functional Collaboration, Escalation Management, Fact-Based Decision Making, Finance and Accounting Platforms, Financial Reports, Market Access Reimbursement, Market Opportunity Assessment, Performance Measurement, Pricing Strategies, Process Improvements, Strategic Thinking, Technical Credibility The Field Reimbursement Manager (FRM) is responsible for serving as the primary field-based lead for education, assistance, and issue resolution with healthcare providers (HCPs), and their office staff, with respect to patient access to J&J Immunology therapies.
Sr. Revenue Cycle Billing Specialist Firstsource Solutions LtdSr. Revenue Cycle Billing SpecialistNY$30–$40 / hourThis role identifies root causes of denials, executes appeals and corrective actions, and collaborates with internal teams to prevent future denials. Work claims across all top denial categories including, but not limited to: No Authorization, Timely Filing, Coordination of Benefits (COB), Medical Necessity, Additional Documentation Requests (ADR), Bundling (NCCI edits), and Duplicate Claims.
Insurance Authorization Specialist - NYC Human HireInsurance Authorization Specialist - NYCNew York, NYHumanHire is a national executive search and staffing firm with a leadership team that has over 50 years of experience as trusted industry professionals specializing in direct hire, temp to hire, temporary and payrolling services. If this is not the ideal position for you but are still interested in hearing about what other job opportunities are in your area, please visit www.humanhirellc.com and email your resume to jobs[at]humanhirellc.com!
Inpatient Medical Coder FT - Up to $5k Sign-on Bonus Datavant LLCInpatient Medical Coder FT - Up to $5k Sign-on BonusNYRemote$32–$42 / hourGuided 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. What Helps You Stand Out: Associate or Bachelor''s degree from an AHIMA-certified HIM or Nursing Program, or completion of a certificate program from AHIMA/AAPC with a preference for CCS.
NewAccounts Receivable Representative I Hospital for Special SurgeryAccounts Receivable Representative INew York, NYThe salary of the finalist selected for this role will be determined based on various factors, including but not limited to: scope of role, level of experience, education, accomplishments, internal equity, budget, and subject to Fair Market Value evaluation. Maintains Documentation & Manages Information - Maintains tracking logs Creates and maintains tracking logs for Insurance Payor issues and accountability for closing out items.
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.
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.
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.
Billing Compliance Specialist Weill Cornell Medical CollegeBilling Compliance SpecialistNew York, NY$79,400–$90,200 / yearCornell welcomes students, faculty, and staff with diverse backgrounds from across the globe to pursue world-class education and career opportunities, to further the founding principle of "any person, any study." Cornell University embraces diversity in its workforce and seeks job candidates who will contribute to a climate that supports students, faculty, and staff of all identities and backgrounds.
Revenue Integrity Analyst Hunterdon HealthRevenue Integrity AnalystFlemington, NJPositionSummary The Revenue Integrity Analyst (RIA), reporting directly to the Chief Revenue Officer will serve as a critical leader of the revenue cycle operation team and be responsible for performing in-depth analysis of patient clinical and billing data to identify contractual, documentation, and denial prevention opportunities with the focus on creating process improvement initiatives. 2. Performs ad hoc consultative research and coordination on current issues of Revenue Cycle regulatory risk including medical necessity denials; identifies a framework of continuous improvement to accomplish programmatic goals; facilitates meetings both internal and external; works collaboratively with system compliance leadership to coordinate and manage RAC and payer audit appeals.
Physician Assistant or Nurse Practitioner URGENT CARE CLINIC PLLCPhysician Assistant or Nurse PractitionerSOUTHAMPTON, PAFull timeThe Physician Assistant or Nurse Practitioner will be responsible for providing medical care to patients, conducting physical exams, diagnosing illnesses, prescribing medications, and developing treatment plans, as well as performing treatment procedures. Join our team and make a difference in the lives of our patients by delivering exceptional healthcare services!
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.
Lead, Medical Network Claims Pricer Capital Rx, Inc.Lead, Medical Network Claims PricerNew York, NY$128,000–$160,000 / yearApply Medicare-based pricing, Reference-Based Pricing (RBP), fee schedules, resource-based relative value methodologies, diagnosis-related groups, ambulatory payment classifications, per-diem rates, case rates, percent-of-charge arrangements, stop-loss provisions, and other approved reimbursement approaches. Advanced knowledge of procedure, revenue, diagnosis, and modifier logic; physician fee schedules; resource-based relative value methodologies; diagnosis-related groups; ambulatory payment classifications; per-diem, case-rate, percent-of-charge, and other medical reimbursement arrangements.
Clinical Documentation Specialist I - Remote Mount Sinai Health SystemClinical Documentation Specialist I - RemoteNew York, NYRemote$65,885–$98,827 / 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.