Lead, Medical Network Pricer Capital Rx LLCLead, Medical Network 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.
Forward Deployed Software Engineering - Senior Manager PwCForward Deployed Software Engineering - Senior ManagerNew York, NY$124,000–$335,000 / yearPwC does not intend to hire experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth within the following policy: https://pwc.to/H-1B-Lottery-Policy . Your ability to direct teams through complexity, demonstrate composure in challenging situations, and initiate open coaching conversations will be key to resolving issues and enhancing team effectiveness.
NewSenior Firmware Engineer, BIOS CoreWeaveSenior Firmware Engineer, BIOSNew York, NY / Sunnyvale$182,000–$242,000 / yearTo conform to U.S. Government export regulations applicable to that information, applicant must either be (A) a U.S. person, defined as a (i) U.S. citizen or national, (ii) U.S. lawful permanent resident (green card holder), (iii) refugee under 8 U.S.C. § 1157, or (iv) asylee under 8 U.S.C. § 1158, (B) eligible to access the export controlled information without a required export authorization, or (C) eligible and reasonably likely to obtain the required export authorization from the applicable U.S. government agency. You will architect and refine mission-critical systems on state-of-the-art server platforms and next-generation silicon, exercising end-to-end ownership of core firmware components from conceptual design through global deployment, while collaborating with industry-leading innovators to define the future of high-performance cloud computing.
ML Engineer R37 Lab, R1 RCMML EngineerNew York, New York$140,000–$300,000 / yearPhare Health is now part of R1 and its AI innovation engine, R37 Lab , bringing Phare’s frontier clinical reasoning technology together with one of the largest healthcare platforms in the U.S. At R37 and Phare, we are building the first AI-native Healthcare Revenue Operating System : a connected platform that reasons over full medical records, payer logic, and financial workflows to automate medical coding, billing, and follow-up. As a ML Engineer, you’ll lead the development of early-phase, high-impact ML systems; own the internal ML dev environment (instrumentation, benchmarking, experimentation);and help bring scientific rigor into production environments, so ideas move rapidly from research to validated pipelines.
Research Scientist R37 Lab, R1 RCMResearch ScientistNew York, New York$140,000–$300,000 / yearPhare Health is now part of R1 and its AI innovation engine, R37 Lab , bringing Phare’s frontier clinical reasoning technology together with one of the largest healthcare platforms in the U.S. At R37 and Phare, we are building the first AI-native Healthcare Revenue Operating System : a connected platform that reasons over full medical records, payer logic, and financial workflows to automate medical coding, billing, and follow-up. The Company’s employment practices, including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law.
Medical Coding Reviewer - Risk Adjustment GuideWell Mutual Holding CorpMedical Coding Reviewer - Risk AdjustmentNY$28–$45 / hourManager Risk Adjustment Audit, the Risk Adjustment Coder is responsible for reviewing medical records to apply appropriate diagnosis coding in compliance with International Classification of Diseases, Tenth Revision (ICD-10) coding guidelines for the purposes of risk adjustment. Review and validate provider-submitted and/or vendor-submitted medical record documentation and ICD-10 diagnosis codes to identify and correct any inaccuracies or discrepancies to ensure accuracy and compliance of risk adjustment.
Medical Office Manager The Cardiovascular Care GroupMedical Office ManagerClifton, NJOversee revenue cycle activities, including coding accuracy, charge capture, prior authorizations, claim submissions, denials management, collections, and collaboration with billing teams. Manage clinical and patient support functions, including prescription refills, patient clinical inquiries, disability forms, CT/MRI authorizations, and weekly chart preparation.
Supervisor, Education/Audit, Physician Billing Hackensack Meridian HealthSupervisor, Education/Audit, Physician BillingEdison, New JerseyRemoteFull timeUnder the general direction of the Physician Billing (PB) Director of Coding and Manager of Education and Audit, the Supervisor, Education/Audit, Physician Billing will supervise the Coding Education and Audit team and conducts audits for medical provider documentation while adhering to Centers for Medicare and Medicaid Services (CMS) and Office of Inspector General (OIG) guidelines for Hackensack Meridian Health (HMH). The posted rate of pay in this job posting is a reasonable good faith estimate of the minimum base pay for this role at the time of posting in accordance with the New Jersey Pay Transparency Act and does not reflect the full value of our market-competitive total rewards package.
NewSoftware Engineer, Code Quality DoorDash IncSoftware Engineer, Code QualityNew York, NY$159,800–$235,000 / yearWe value a diverse workforce - people who identify as women, non-binary or gender non-conforming, LGBTQIA+, American Indian or Native Alaskan, Black or African American, Hispanic or Latinx, Native Hawaiian or Other Pacific Islander, differently-abled, caretakers and parents, and veterans are strongly encouraged to apply. We''re looking for Software Engineers to help build and maintain the systems that validate code quality across DoorDash''s engineering org, treating our tooling as a critical product for the engineers who rely on it every day: static analysis and quality gates, test frameworks and regression infrastructure.
Inpatient Medical Coder PRN – Up to $1k Sign-on Bonus DatavantInpatient Medical Coder PRN – Up to $1k Sign-on BonusNew York, NYRemote$32–$42 / hourThe estimated base pay range per hour for this role is: $32—$42 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. 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 Associate The Cardiovascular Care GroupMedical Records AssociateNJConsistently recognized by their peers and patients as the top group in the region, The Cardiovascular Care Group provides the highest quality care using the newest technologies in the setting of years of experience with outstanding results. Effective communication skills facilitate collaboration with healthcare providers and administrative personnel to resolve documentation issues and support quality patient care.
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.
Engagement Manager, Revenue Cycle Chartis Group LLCEngagement Manager, Revenue CycleNYRemote$137,000–$180,000 / yearEngagement Managers lead work across a portfolio of client engagements, structuring workplans, managing teams, and partnering directly with client stakeholders to turn insights into practical, sustainable improvements across the revenue cycle. The salary range for this role takes into account the wide range of factors that are considered in making compensation decisions including, but not limited to, skills, experience, training, licensure and certifications, practice area, and other business and organizational needs.
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.
NewAssociate Billing Representative Clerk Surgical Care Affiliates LLCAssociate Billing Representative ClerkNYAs part of Optum, SCA Health is redefining specialty care by developing more accessible, patient-centered practice solutions for a network of more than 370 ambulatory surgical centers, over 400 specialty physician practice clinics and numerous labs and surgical hospitals. The Associate Billing Representative Clerk takes coded patient visits and enters the charges into the systems, submits the claim to the insurance company, and works on rejections they may receive with our A/R collections team.
Medical Billing Specialist - Denials Sonic Healthcare USA IncMedical Billing Specialist - DenialsHicksville, NY$18–$24 / hourUse established protocols to contact providers and clients to resolve discrepancies in processed, partially paid and unpaid claims with timely appropriate follow up action. We offer Medical, Vision and Dental Insurance | Short Term and Long-Term disability | Voluntary term life | 401-K plus match | Paid Time Off| Paid holidays.
RCM Customer Service Specialist The Dermatology SpecialistsRCM Customer Service SpecialistLong IslandThe role handles inquiries via phone, email, and EMR-tasked billing requests, assists patients with billing questions, and ensures accurate interpretation of Explanation of Benefits (EOBs), payment postings, and claim denials. The CSR collaborates with the Revenue Cycle team and Ops team to support timely resolution, maintain high patient satisfaction, and improve financial outcomes for the dermatology practice.
CPC Investigator Blue Cross and Blue Shield AssociationCPC InvestigatorNewark, NJ$70,500–$94,395 / yearThe Certified Professional Coder (CPC) is responsible for performing reviews, audits and coding oversight of medical records to ensure the appropriate CPT codes, diagnosis codes and modifiers according to Generally Accepted Medical Coding Guidelines, CPT-4; HCPCS; ICD-10 Guidelines; and, CMS Correct Coding. The incumbent will also be responsible for handling low level investigative activities (external) related to claims, enrollment, accounting, receive and review suspected fraud and to complete cases with all information and analysis for resolution, as the manager and prior approved guidelines may direct.
NewCDI Second Level Reviewer Catholic HealthCDI Second Level ReviewerMelville, New York$145,000–$180,000 / yearThis role focuses on identifying documentation opportunities in complex or high-risk cases to ensure accurate representation of patient acuity, quality outcomes (such as expected mortality), and financial performance. Job Details: The CDI Second Level Reviewer is an experienced Clinical Documentation Specialist responsible for performing advanced, targeted case reviews on potentially high-impact encounters.
DRG Clinical Validation Nurse MedReviewDRG Clinical Validation NurseManhattan, NY$85,000–$95,000 / yearSolid understanding of anatomy and physiology, diagnostic and surgical procedures developed from specialized training and extensive experience with ICD-10-PCS code assignments. Here is what we are searching for: Responsibilities: Perform clinical validation by ensuring diagnosis codes billed by the provider are supported within the medical record.