Outpatient Audit Specialist PRN - Remote Datavant LLCOutpatient Audit Specialist PRN - RemoteNYRemote$35–$45 / hourWhat We're Looking For: As an Outpatient Auditing Specialist, you will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, and coding workflow operations reviews. 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.
Psychotherapist (LPC/LCSW/LMFT/Art Therapist) Konnect TherapyPsychotherapist (LPC/LCSW/LMFT/Art Therapist)Iselin, New Jersey$40–$60Demonstrated expertise in psychotherapy techniques such as motivational interviewing, behavioral therapy, psychodynamic therapy, grief counseling, PTSD care, addiction counseling, and crisis management. Deliver individual, group, and family counseling sessions utilizing modalities such as cognitive behavioral therapy (CBT), psychodynamic therapy, art therapy, DBT, TF-CBT, ERP, EMDR.
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.
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.
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.
NewMgr Multi Facility CDI SCDNNJ Medical Records Fac#01 Prime Healthcare Services IncMgr Multi Facility CDI SCDNNJ Medical Records Fac#01Denville, NJSaint Clare''s Health includes CMS 5-Star Rated hospitals and is an award-winning provider of safe, high quality, compassionate care, serving the communities of Morris, Warren and Sussex counties. The Multi-Facility CDI Manager will work closely with the Chief Financial Officer and Director of HIM at the individual facility to be instrumental in supplementing assistance to these departmental functions pertaining to clinical documentation and inpatient coding.
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.
Clinical Research Billing Analyst VitaliefClinical Research Billing AnalystNew Brunswick, NJ$75,000–$110,000 / yearBy combining deep subject matter expertise with the experience of senior research practitioners, we help organizations accelerate study activation, optimize operations, improve financial performance, and build scalable workforce solutions that reduce costs, increase efficiency, and advance clinical breakthroughs for patients. The Analyst collaborates with Clinical Trial Finance, Revenue Cycle, Research Operations, study teams, investigators, IRB, and other stakeholders to resolve billing issues, improve processes, and ensure accurate, compliant research revenue cycle operations.
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.
Quality Analyst - Clinical Validation Audit ExlService Holdings IncQuality Analyst - Clinical Validation AuditNYRemote$85,000–$100,000 / yearResponsible for reviewing the accuracy and consistency of clinical DRG auditing auditors to ensure audits are appropriately marked for findings and no findings. For positions based in higher-cost zones (e.g., California, New York, New Jersey), actual compensation may exceed the posted range; your recruiter will share specifics during the process.
Supervisor of Revenue Cycle and Credentialing Henry J. Austin Health Center IncSupervisor of Revenue Cycle and CredentialingTrenton, NJ$65,400–$94,200 / yearThe Supervisor monitors billing, collections, audits, credentialing, recredentialing, payer enrollment, denial trends, Medicaid WRAP activity, LOA (NJ state letter of agreement) billing processes, and reimbursement performance while supporting workflow optimization within Dental and Medical EMR or software platforms Working collaboratively with Patient Access, Clinical Operations, Finance, IT, and external partners, the Supervisor identifies and resolves operational and reimbursement issues, promotes data integrity and reporting accuracy, and supports continuous process improvement to enhance organizational performance and revenue outcomes. The Supervisor of Revenue Cycle and Credentialing works under the direction of the Director of Revenue Cycle and Credentialing to oversee daily revenue cycle and provider credentialing operations, ensuring accurate billing, timely payer enrollment, reimbursement integrity, and compliance with federal, state, payer, HRSA, and NCQA requirements.
Facility-Fee Emergency Department Medical Coder Sutherland Global Services IncFacility-Fee Emergency Department Medical CoderClifton, NJThe Facility-Fee Emergency Department Medical Coder is responsible for the accurate review, abstraction, and assignment of ICD-10-CM, CPT, HCPCS, facility-specific charging methodologies, and applicable modifiers for Emergency Department (ED) facility encounters. The coder will review clinical documentation, emergency department records, physician documentation, nursing notes, ancillary reports, and charging information to accurately capture facility services rendered during emergency department visits.
Medical Records Coder II, Full Time, Family Medicine, Summit Atlantic Health System IncMedical Records Coder II, Full Time, Family Medicine, SummitSummit, NJAtlantic Medical Group is a physician-led and physician-governed organization that delivers the highest quality health care, at the right place, the right price, and the right time. We are a multispecialty physician group with more than 1,000 doctors, nurse practitioners and physician assistants at over 300 locations throughout northern and central New Jersey and northeast Pennsylvania.
Senior Consultant, Revenue Cycle And Financial Operations | Healthcare Business Transformation FTI Consulting, Inc.Senior Consultant, Revenue Cycle And Financial Operations | Healthcare Business TransformationNew York, NYThe Senior Consultant in Revenue Cycle and Financial Operations within our Healthcare Business Transformation practice plays a key leadership role advising physician groups, health systems, private equity and technology companies on strategies to optimize financial performance and operating effectiveness across the revenue cycle. This role supports complex client engagements from assessment through implementation, partners directly with client executives to align initiatives to enterprise priorities, and delivers measurable outcomes related to cost optimization, revenue enhancement, technology implementation and financial operations.
Senior Consultant, Revenue Cycle and Financial Operations | Healthcare Business Transformation FTI Consulting IncSenior Consultant, Revenue Cycle and Financial Operations | Healthcare Business TransformationNew York, NYThe Senior Consultant in Revenue Cycle and Financial Operations within our Healthcare Business Transformation practice plays a key leadership role advising physician groups, health systems, private equity and technology companies on strategies to optimize financial performance and operating effectiveness across the revenue cycle. This role supports complex client engagements from assessment through implementation, partners directly with client executives to align initiatives to enterprise priorities, and delivers measurable outcomes related to cost optimization, revenue enhancement, technology implementation and financial operations.
Senior Manager, Neuroscience And Cardiovascular Patient Access Strategy And Marketing Bristol Myers SquibbSenior Manager, Neuroscience And Cardiovascular Patient Access Strategy And MarketingPrinceton, NJ$141,310–$171,238 / yearSummary: The Senior Manager, Neuroscience and Cardiovascular Patient Access Strategy and Marketing will play a key role in the management of our Patient Access & Support Services (PASS) across the BMS portfolio with a primary focus on Neuroscience and Cardiovascular patient support programs. Manages hub relations and activities (e.g., complex ways of working, start forms, patient contact, escalations, denials, coding, training, business reviews, staffing updates, program claims, invoices, and activity monitoring).
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.
Diagnosis-Related Group (DRG) Auditor III ExlService Holdings IncDiagnosis-Related Group (DRG) Auditor IIINYRemote$73,000–$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.
NewDRG Quality Manager ExlService Holdings IncDRG Quality ManagerNYRemote$100,000–$120,000 / yearThe role directly manages a team of DRG quality analysts responsible for reviewing auditor-completed MS-DRG and APR-DRG work, validating audit accuracy, and ensuring accurate coding and reimbursement outcomes. High-quality, accurate, timely, and consistent quality review results across DRG and assigned programs, including correct DRG validation, clinical support, coding guideline application, and audit rationale quality.
Manager, Data Mining - Payment Integrity Oscar Health IncManager, 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.