Call Center Representative Human HireCall Center RepresentativeWhite Plains, 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!
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.
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.
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).
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.
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.
NewField Ancillary Support Specialist Tristate HRHField Ancillary Support SpecialistJersey City, NJ$15.92–$30Tristate HRH Outreach Management is a growing healthcare services organization that provides on-site staffing and operational support for one of Hudson County’s leading health systems. Our employees play a vital part in the patient experience by supporting day-to-day operations, coordinating workflows, and ensuring that clinical teams can focus on delivering care.
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 Account Representative - Remote Med-Metrix, LLCPatient Account Representative - RemoteRed Bank, NJRemotePhysical 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.
NewPayment Operations Associate Maven ClinicPayment Operations AssociateNew York, NY$81,000–$95,000 / yearThrough Maven Enterprise, the company partners with more than 2,300 employers and health plans to provide end-to-end women's and family health programs spanning fertility and family building, maternity and newborn care, parenting and pediatrics, and menopause and midlife — improving clinical outcomes, reducing healthcare costs, and expanding equitable access to high-quality care at scale. Our teams primarily operate from the New York Metropolitan area, NY, and remotely via San Francisco/Bay Area, CA, Seattle, WA, Boston, MA, Chicago, IL, and Washington, D.C. For those in our New York City office, we encourage in-person collaboration by requiring team members to work onsite three days a week (Tuesday, Wednesday, Thursday).
Medical Director, General Surgery - Remote UnitedHealth Group IncMedical Director, General Surgery - RemoteNew York, NYRemote$248,500–$373,000 / yearWe are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes.
ConvergeHEALTH - Forward Deployed Engineer, Data Studio Revenue Cycle - Innovation_Delivery_Transformation Deloitte Touche Tohmatsu LtdConvergeHEALTH - Forward Deployed Engineer, Data Studio Revenue Cycle - Innovation_Delivery_TransformationNew York, NY$105,400–$207,800 / yearWorking knowledge of the retrieval and knowledge layer behind agentic systems - RAG pipelines, embeddings and vector stores, and increasingly knowledge graphs - including how to ground use cases in large volumes of unstructured healthcare data (e.g., clinical notes, payer policies, contracts) alongside structured sources. Partner with Health Care consulting teams and Converge for Healthcare's account and product teams during the sales cycle - running technical discovery, demonstrations, and use-case fit assessments - such as denial prevention, prior authorization automation, or AR follow-up - that qualify client needs and shape a credible path to production value.
Senior Manager, Field Reimbursement PhilipsSenior Manager, Field ReimbursementNY$133,000–$212,000 / yearYour skills include demonstrated outstanding knowledge and strong understanding of US healthcare coding and billing systems, Medicare and commercial payers, hospital infrastructure, reimbursement policies and processes, and possesses expertise in data analysis, health economic evidence, and documentation. The Senior Manager, Field Reimbursement leads customer education and engagement on coding, coverage, payment, and payer policy for Philips Image Guided Therapy Device products, helping reduce reimbursement and economic barriers for U.S. patients and providers.
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.
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.
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.