Risk Adjustment Expert - Fully Remote MercorRisk Adjustment Expert - Fully RemoteNew York, New YorkRemote5+ years of experience in risk adjustment coding , HCC coding , or Medicare Advantage coding operations , with at least 2 years in a leadership role. Lead risk adjustment and HCC coding operations across Medicare Advantage , Medicaid , and ACA risk adjustment programs.
ProFee Audit Specialist- PRN DatavantProFee Audit Specialist- PRNNew York, NYRemote$35–$45 / hourAs a Profee Auditing Specialist, you will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, interim coding management, and coding workflow operations reviews. The estimated base pay range per hour for this role is: $35—$45 USD To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc.
HIM Coder - Remote/Mt. Holly (FT) CCS Required Virtua Health IncHIM Coder - Remote/Mt. Holly (FT) CCS RequiredMt. Holly, NJRemote$26.22–$40.65 / hourPosition Responsibilities: Accurately reviews each record and knowledgeably utilizes ICD-10-CM, ICD-10-PCS, CPT-4, and encoder to accurately code all significant diagnoses and procedures according to American Hospital Association (AHA), American Health Information Management Association (AHIMA), Uniform Hospital Discharge Data Set (UHDDS) hospital specific guidelines and rules/conventions. Remote Type: On-Site Employment Type: Employee Employment Classification: Regular Time Type: Full time Work Shift: 1st Shift (United States of America) Total Weekly Hours: 40 Additional Locations: Job Information: Please note all candidates must complete & pass onsite testing in Marlton, NJ prior to an interview.
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.
Med Records Coder III University of RochesterMed Records Coder IIINew York, NY$21.78–$30.53 / hourAmerican Health Information Management Association (AHIMA) accreditation examination for Registered Health Information Administrator (RHIA) or (Registered Health Information Technician) RHIT or Certified Coding Specialist (CCS) preferred. Uses knowledge of coding systems and system logic to review codes created by electronic charge capture and/or assigns codes through medical record documentation as per designated workflow.
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.
Principal Data Manager I Everest Clinical ResearchPrincipal Data Manager IBridgewater, New JerseyRemoteTo drive continued success in this exciting clinical research field, we are seeking committed, skilled, and customer-focused individuals to join our winning team as Principal Clinical Data Manager for our Bridgewater, New Jersey, USA on-site location, or remotely from a home-based office anywhere in the USA in accordance with our Work from Home policy. When these tasks are assigned to Data Management support team members, the Principal Clinical Data Manager is responsible for review or to provide data management oversight and approvals for the task performed to ensure quality deliverable, including review of UAT plans to ensure accuracy and consistency among projects.
Clinical Research Scientist NovoCure LtdClinical Research ScientistNY$125,000–$185,000 / yearBeyond contributing to protocol development, clinical strategy, and data interpretation, youll build meaningful partnerships with investigators, participate in study-related site activities, and help ensure the successful execution of clinical trials from concept through completion. Working at the intersection of science and operations, youll collaborate with cross-functional teams across Clinical Development, Clinical Operations, Medical Affairs, Data Management, Regulatory Affairs, Safety, and Device Support Specialists.
Senior Hospital Clinical Documentation Improvement Specialist - FT - Day - Clinical Documentation Improvement Lawrenceville NJ Capital HealthSenior Hospital Clinical Documentation Improvement Specialist - FT - Day - Clinical Documentation Improvement Lawrenceville NJNJ$90,480–$118,227.20 / yearExperience: Three or more years' recent clinical experience in an acute care setting, preferable ICU or Medical/Surgical, or three or more years related coding experience or clinical documentation improvement specialist experience in a hospital setting in clinical documentation improvement in an acute care setting. Supports escalated documentation issues, mentors CDI team members, and collaborates with physicians, coding, and revenue cycle leadership to improve clinical documentation that impacts reimbursement, quality reporting, and patient outcomes.
Manager, Data Mining - Payment Integrity Oscar Health InsuranceManager, Data Mining - Payment IntegrityNew York, NY$111,780–$146,711 / yearAbout the role: The Manager of Data Mining leads a team of individual contributors, ensuring the team is meeting savings and recovery targets in the payment integrity space. Work Location: This position is based in our New York City office, requiring a hybrid work schedule with 3 days of in-office work per week.
NewManager, Data Mining - Payment Integrity Oscar HealthManager, Data Mining - Payment IntegrityNew York, NY$111,780–$146,711 / yearThe Manager of Data Mining leads a team of individual contributors, ensuring the team is meeting savings and recovery targets in the payment integrity space. Work Location: This position is based in our New York City office, requiring a hybrid work schedule with 3 days of in-office work per week.
DRG Downgrade Denial Specialist - FT - Day - Revenue Integrity & Denials Mgmt Lawrenceville NJ Capital HealthDRG Downgrade Denial Specialist - FT - Day - Revenue Integrity & Denials Mgmt Lawrenceville NJNJ$20.10–$26.13 / hourKnowledge and Skills: Working knowledge of DRG downgrade processes and third-party audit workflows Strong understanding of hospital billing systems and payer claim adjudication processes Ability to perform detailed tracking, documentation, and inventory management across multiple appeal levels Strong organizational skills and attention to detail Ability to perform root-cause analysis and identify recurring downgrade drivers Strong written communication skills for documentation and internal coordination. Ensures DRG downgrade cases are properly triaged, routed, documented, tracked, and submitted in accordance with payer and auditor requirements, while partnering with clinical resources to support successful appeal outcomes and denial prevention.
Executive Medical Director, Neurology, Clinical Development Katalyst Healthcares & Life SciencesExecutive 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.
Director, Clinical Data Management PTC TherapeuticsDirector, Clinical Data ManagementWarren, NJ$200,700–$252,600 / yearThe Director, Clinical Data Management provides strategic and operational leadership and oversight of data management activities to ensure the quality, integrity, consistency and inspection readiness of clinical databases for subsequent analysis, reporting and regulatory submissions. Participate in cross functional team meetings, as requested, and communicate with all departments regarding project statuses/issues, provide ongoing feedback on data management workflows to increase efficiency and provide feedback to CRAs.
Associate Director, Clinical Data Management PTC TherapeuticsAssociate Director, Clinical Data ManagementWarren, NJ$163,800–$206,200 / yearParticipate in cross functional team meetings, as requested, and communicate with all departments regarding project statuses/issues, provide ongoing feedback on data management workflows to increase efficiency and provide feedback to CRAs. The Associate Director, Clinical Data Management is responsible for providing leadership and oversight of data management activities to ensure accuracy and consistency of clinical databases for subsequent analysis and reporting.
Clinical Data AMS Sr. Consultant DeloitteClinical Data AMS Sr. ConsultantPrinceton, NJ$120,200–$140,000 / yearThis role owns the health, stability, and compliance posture of a suite of clinical and regulatory R&D platforms - including Axway Secure Transport (ST), eClinical Elluminate, Eclipse (medical coding), and EAST - across the full engagement lifecycle: implementation, configuration, validation, and steady-state managed services. The team operates at the intersection of IT infrastructure, clinical operations, and quality/regulatory compliance, partnering closely with global business and technology stakeholders to support end-to-end clinical trial data lifecycles from data capture and coding through statistical analysis and submission-ready outputs.
Revenue Cycle Executive - AI Strategy MercorRevenue Cycle Executive - AI StrategyNew York, New YorkRemoteProvide executive-level oversight and strategic direction for end-to-end revenue cycle operations, including patient access, coding, billing, denials, and collections. Define and monitor enterprise revenue cycle KPIs , including net collection rate, days in A/R, denial rate, cost-to-collect, and cash collections performance.
RCM Analytics Director - AI Tools MercorRCM Analytics Director - AI ToolsNew York, New YorkRemote5+ years of experience in revenue cycle analytics, RCM reporting , or healthcare financial decision-support, with at least 2 years in a leadership role. Lead revenue cycle analytics, reporting, and decision-support functions to drive data-driven performance improvement across RCM operations .
Revenue Cycle Leader - Fully Remote MercorRevenue Cycle Leader - Fully RemoteNew York, New YorkRemote5+ years of experience in revenue cycle analytics, RCM reporting , or healthcare financial decision-support, with at least 2 years in a leadership role. Lead revenue cycle analytics, reporting, and decision-support functions to drive data-driven performance improvement across RCM operations .
Denials Management Expert - Analytics MercorDenials Management Expert - AnalyticsNew York, New YorkRemote$70–$93 / hourDeep knowledge of CARC/RARC denial codes, payer denial patterns, and appeal strategies across commercial, Medicare, and Medicaid payers. 5+ years of experience in denials management, appeals, or revenue cycle operations, with at least 2 years in a management role.