Prior 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.
Assistant Director (FGP), Revenue Optimization & Analytics - Radiology, Manhattan New York University School of MedicineAssistant Director (FGP), Revenue Optimization & Analytics - Radiology, ManhattanNew York, NY$121,792.22–$210,091.64 / yearWork closely with departmental and revenue cycle leadership on initiatives that target revenue optimization for radiology services, including identifying bottlenecks, analyzing root causes, and implementing corrective measures. Regularly meet with Department Chair and his leadership team to present revenue cycle insights, address payor issues, and review opportunities for improvement using practice-specific and departmental data.
Senior Inpatient Coder Westchester Medical Center Health NetworkSenior Inpatient CoderValhalla, NY$39.66–$49.86 / hourJob Details: Job Summary: The Senior Inpatient Coder is responsible for addressing appeals to insurance companies and coding highly complex medical records using the current International Classification of Diseases (ICD10 CM/PCS codes) and entering coded information into an automated grouper system. Job Category Job Category Allied Health Prof/Technical Clerical/Administrative Support clerical/Administrative Supportc Executive/Management Finance/Info Systems Nursing Support Nursing/Nursing Management Physicians Professional/Non-Clinical Service/Trades.
Claims 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.
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).
IBR Senior Analyst Zelis Healthcare, Inc.IBR Senior AnalystNJ$79,000–$99,750 / yearThis 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. The Itemized Bill Review Senior Analyst will be responsible for analyzing hospital claims for adherence to proper billing guidelines and will work closely with Expert Claims Review staff to efficiently adhere to policies and procedures for claims processing.
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.
Pre Service Rep - Patient Access Central - Full Time Day Shift (23944) Bergen New Bridge Medical CenterPre Service Rep - Patient Access Central - Full Time Day Shift (23944)Paramus, New JerseyThe preservice representative assures that all patients have all information they need so that they will arrive on time and prepared for their appointment and the hospital has all the information required to properly bill or services. Additionally, we are committed to the personal and professional growth of our employees, offering robust tuition reimbursement and continuing education programs to help support our employees ongoing development.
Oncology Authorization Specialist St. Joseph's Healthcare SystemOncology Authorization SpecialistPaterson, NJThe combined efforts of the organization's outstanding physicians, superb nurses, and dedicated clinical and professional staff have made us one of the most highly respected healthcare organizations in the state, the largest employer in Passaic County, and one of the nation's "100 Best Places to Work in Health Care". Key responsibilities include verifying insurance coverage, obtaining necessary authorizations, and providing clear cost estimates to patients, thereby promoting transparency and reducing financial uncertainty.
Director, Provider Education & Risk Adjustment Metropolitan Jewish Health SystemDirector, Provider Education & Risk AdjustmentNew York, New YorkFull timeThey are responsible for implementation of strategic plans and coordination of all aspects of provider and practice education, including but not limited to scheduling, tracking, follow-up, workflow integration, medical record documentation, coding, and electronic health records. • Analyze medical record documentation and coding through a chart review process that identifies incorrect coding, coding lacking supporting documentation, and missed opportunities to capture risk adjustment diagnoses and associated revenue.
Mgr - Multi-Facility CDI - SMNJ Medical Records FAC#1 Saint Michaels Medical CenterMgr - Multi-Facility CDI - SMNJ Medical Records FAC#1Newark, New JerseyFull timeCombining 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.
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.
CDI Specialist Episcopal Health Services IncCDI SpecialistNYAdditionally, St. Johns 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.
Community Pharmacy Team Lead (Thursday to Saturday, 10:00AM - 6:30PM ET) AnewHealthCommunity Pharmacy Team Lead (Thursday to Saturday, 10:00AM - 6:30PM ET)NJRemoteAbility to communicate effectively and professionally through written, verbal (e.g., face-to-face, telephonically and/or virtual communication platforms), and interpersonal skills as applied when interacting with employees, patients, healthcare professionals, clients, or agency representatives; successfully conveying and exchanging information at an appropriate level and in a positive and timely manner. Established in 2023 through the combination of ExactCare and Tabula Rasa HealthCare, we provide a suite of solutions that includes comprehensive pharmacy services; full-service pharmacy benefit management; and specialized support services for Program of All-Inclusive Care for the Elderly.
Software Engineer TP ICAPSoftware EngineerNew York, New YorkCollectively, TP ICAP is the largest interdealer broker in the world by revenue, the number one Energy & Commodities broker in the world, the world’s leading provider of OTC data, and an award winning all-to-all trading platform. As well as representing specific groups, TP ICAP Accord helps increase awareness, collaboration, shares best practice, and holds our firm to account for driving continuous cultural improvement.
Software Engineer TP ICAP Group plcSoftware EngineerNew York, NY$136,000–$175,000 / yearCollectively, TP ICAP is the largest interdealer broker in the world by revenue, the number one Energy & Commodities broker in the world, the worlds leading provider of OTC data, and an award winning all-to-all trading platform. As well as representing specific groups, TP ICAP Accord helps increase awareness, collaboration, shares best practice, and holds our firm to account for driving continuous cultural improvement.
Securities Settlements Engineering Developer, Vice President Citigroup IncSecurities Settlements Engineering Developer, Vice PresidentJersey City, NJ$142,320–$213,480 / yearMust-Have Skills: 10+ years of total experience in financial services software development Programming - Kotlin, Python & Java System Architecture for real-time high throughput performance optimization. This role requires deep expertise in system design, hands-on coding, and strong problem-solving skills to create resilient, high-performing, and secure applications.
Accounts 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.
Inpatient Coder (Remote) Nesco Resource, LLCInpatient Coder (Remote)Garden City, NYRemote$60,000–$65,000 / yearResponsibilities include, but are not limited to: Assign ICD-10-CM/PCS diagnosis and procedure codes in accordance with Official Coding Guidelines, AHA Coding Clinic, CMS, and other regulatory requirements. The Inpatient Coder is responsible for accurately coding and abstracting diagnoses, procedures, and clinical information from inpatient medical records.