Revenue Cycle Supervisor (Self Pay and Specialty) Self Pay and SpecialtyRevenue Cycle Supervisor (Self Pay and Specialty)Fort Lee, New JerseyDemonstrated skills in A/R management, Customer Service, problem assessment, and resolution, and collaborative problem-solving in complex and interdisciplinary settings, including strong proficiency in healthcare and payer guidelines as it pertains to billing and reimbursement. The Revenue Cycle Supervisor (Self Pay and Specialty) will also be responsible for day-to-day operations of the payment posting process, the International Business Line, Specialty billing, and the oversight of guarantor work queues.
Patient Navigator HealogicsPatient NavigatorNorth Bergen, New JerseyLearn more about this role here: Healogics is the largest provider of advanced wound care services in the United States, treating more than 300,000 chronic wound patients annually across over 600 sites. All Healogics employees must perform their job responsibilities according to all Healogics policies, Hospital policies, as well as to accrediting organizations, federal and state regulation, and to the Centers for Medicare and Medicaid Services (CMS) guidelines, as applicable.
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.
Behavioral Health Quality Analyst ExlService Holdings IncBehavioral Health Quality AnalystNYRemote$60,100–$98,700 / yearEXL never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process and has not authorized any agencies or partners to collect any fee or payment from prospective candidates. EXL harnesses the power of data, analytics, AI, and deep industry knowledge to transform operations for the world's leading corporations in industries including insurance, healthcare, banking and financial services, media and retail, among others.
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.
Sr. Call Center Service Assoc Horizon Healthcare ServicesSr. Call Center Service AssocHopewell, New Jersey52,787 - $70,172 This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. Receive escalated customer inquiries and provide second level resolution by initiating or continuing investigation process, utilizing available resources and accurately documenting customer inquiry and actions taken in accordance with departmental quality guidelines.
NewCall Center Service Associate Horizon Healthcare ServicesCall Center Service AssociateHopewell, New Jersey47,961 - $63,820 This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. For over 90 years , we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience.
Training Manager ExlService Holdings IncTraining ManagerNYRemote$100,000–$120,000 / yearEXL never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process and has not authorized any agencies or partners to collect any fee or payment from prospective candidates. The ideal candidate will bring strong people leadership capability, a proven ability to develop high-performing teams, and experience driving training strategy, operational execution, and learner outcomes.
Clinical Documentation Quality Improvement Specialist II-Mount Sinai Brooklyn - Full-time - Day Mount Sinai Health SystemClinical Documentation Quality Improvement Specialist II-Mount Sinai Brooklyn - Full-time - DayBrooklyn, NY$79,720–$108,709 / yearThe Clinical Documentation Quality Improvement Specialist II is responsible for improving the overall quality and completeness of clinical documentation; facilitates modifications to clinical documentation through extensive interaction with physicians, nursing staff, other patient caregivers, and medical records coding staff to ensure that documentation reflects complete and accurate level of service rendered to patients. We 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.
Certified Coder St. Joseph's Healthcare SystemCertified CoderPaterson, 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". This role works closely with providers, clinical staff, and revenue cycle teams to review medical records, validate documentation completeness, apply correct CPT, ICD-10-CM, and HCPCS codes, and educate providers on documentation best practices.
Documentation Review Nurse Hunterdon HealthDocumentation Review NurseFlemington, NJQualifications Minimum Education: Required: Registered Nurse (RN) with an active and unencumbered license Preferred: Bachelor of Science in Nursing (BSN) preferred Minimum Years of Experience (Amount, Type and Variation): Required: Minimum of three (3) years clinical nursing experience Preferred: Previous nursing experience in an emergency department License, Registry or Certification: Required: RN certification Preferred: Knowledge, Skills and/or Abilities: Required: Strong understanding of ICD-10, CPT and HCPCS coding principles Knowledge of Medicare reimbursement and coding structures/systems Preferred: Experience in clinical documentation improvement (CDI), coding or utilization review is highly desirable/preferred Excellent analytical, organizational and communication skills Proficient in electronic health records (EHRs) and clinical documentation systems High level creativity, judgment and initiative, tempered with flexibility to deal with rapidly changing healthcare environment and expanding technology Ability to maintain concentration with attention to detail even in areas containing multiple levels of distraction Self-motivated, well organized and possess confidence and ability to wor work independently and deal with ambiguity and ask critical questions to problem solve issues as required. Primary Position Responsibilities Clinical Documentation Review: Assess emergency department documentation using Emergency Department E/M and Critical Care Facility Charge Assessment tool to ensure the patient documentation accurately reflects the patients clinical presentation, diagnoses, and captures all treatment and services provided.
Outpatient Auditor Manager ExlService Holdings IncOutpatient Auditor ManagerNYRemote$105,000–$115,000 / yearThe role directly manages auditors responsible for outpatient payment integrity reviews, including outpatient facility, ambulatory surgery, emergency department, observation, and professional claim audits. The ideal candidate demonstrates strong leadership and analytical skills, along with expertise in CPT, HCPCS, NCCI edits, CMS outpatient reimbursement methodologies, and payer-specific billing requirements.
Medical Coder LaSante Health CenterMedical CoderBrooklyn, NYLaSante Health Center is seeking a detail-oriented in-person Medical Coder to ensure accurate coding and abstraction of patient encounters. The ideal candidate will possess strong analytical skills, attention to detail, and expertise in coding conventions.
Principal, Medical Economics Evergreen Nephrology LLCPrincipal, Medical EconomicsNY$135,000–$150,000 / yearThis role will help ensure the integrity of claims data flowing into enterprise datasets, enable more sophisticated economic and impact modeling, and connect cost insights with clinical and risk stratification efforts to support value-based care performance. Partner with data, actuarial, and analytics teams to validate healthcare claims data structures, ensure data is accurately represented in enterprise datasets, and resolve discrepancies affecting downstream reporting and analysis.
Senior Analyst, Payment Integrity Disputes Oscar Health IncSenior Analyst, Payment Integrity DisputesNew York, NYRemote$64,832–$85,092 / yearYou will leverage a deep understanding of Oscar''s claim infrastructure, workflows, workflow tooling, platform logic, data models, etc., to work cross-functionally and understand and translate friction from stakeholders into actionable opportunities for improvement. Work Location: This is a remote position, open to candidates who reside in: Atlanta, Georgia; Chicago, Illinois; Dallas, Texas; Louisville, Kentucky; Minneapolis, Minnesota; Philadelphia, Pennsylvania; Salt Lake City, Utah.
Senior Analyst, Payment Integrity Oscar Health IncSenior Analyst, Payment IntegrityNew York, NYRemote$64,832–$85,092 / yearThis is accomplished by leveraging a deep understanding of Oscar's claim infrastructure, workflows, workflow tooling, platform logic, data models, etc., to work cross-functionally to understand and translate friction from stakeholders into actionable opportunities for improvement. Work Location: This is a remote position, open to candidates who reside in: Atlanta, Georgia; Chicago, Illinois; Dallas, Texas; Louisville, Kentucky; Minneapolis, Minnesota; Philadelphia, Pennsylvania; Salt Lake City, Utah.
Per Diem, Advanced Practice Clinician VNS HealthPer Diem, Advanced Practice ClinicianNew York, NY$58.30–$77.72 / hourLicenses and Certifications: License and current registration to practice as a Registered Professional Nurse in New York State required Certificate (license) and current registration to practice as a Nurse Practitioner in the State of New York, with a specialty in adult health, family health or gerontology required Valid driver's license, as determined by operational/regional needs may be required Maintains credentialed status with VNS Health Medical Care at Home and associated managed care plans required Maintains NPI, Medicaid and Medicare provider numbers preferred Maintains a collaborative practice agreement with a physician in compliance with New York State regulations preferred Must be certified by ANCC or another accrediting Nurse Practitioner body - in order to bill Medicare and meet credentialing requirements required For Psychiatric Nurse Practitioners only: Current PMHNP-BC certification required. Work Experience: Minimum of two years of experience as a nurse practitioner utilizing full scope of practice preferred Clinical home care experience or two years managerial experience preferred Demonstrated knowledge of Hedis and QARR quality measures, ICD-10 and CPT coding for reimbursement of services required Bilingual skills, as determined by operational needs required For Psychiatric Nurse Practitioners only: Minimum of two years of experience as a psychiatric nurse practitioner utilizing full scope of practice required.