NewClaims 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.
Remote Pediatric Medical Coder - PICU / Neonatology (ProFee) UCSF Medical CenterRemote Pediatric Medical Coder - PICU / Neonatology (ProFee)NYRemote$50.61–$63.01 / hourThe University of California, San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. Resolve Claims Manager and Epic edits to ensure correct coding of services provided, including review of documentation for correct coding, evaluation and management (E/M) leveling, diagnosis coding, bundling issues, and modifier usage.
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.
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.
VP Quantitative Sciences & Development Astera SearchVP Quantitative Sciences & DevelopmentParamus, New JerseyA well-established, secure and commercially active biopharma is looking to bring on a Vice President, Quantitative Sciences & Development to lead Clinical Pharmacology, Pharmacometrics, Toxicology, DMPK, Biostatistics, Statistical Programming, and Clinical Data Management across all phases of drug development. Build and mentor high-performing teams across Clinical Pharmacology, Biometrics, and Data Management, recruiting and retaining top scientific and operational talent.
Clinical Documentation Expert - Fully Remote MercorClinical Documentation Expert - Fully RemoteNew York, New YorkRemoteMonitor CDI program KPIs, including query response rates, CC/MCC capture rates, case mix index, and DRG accuracy. 5+ years of experience in clinical documentation integrity or improvement, with 2+ years in a manager or leadership role.
Data Scientist - Clinical Informatics (Analytics Enablement) CVS Health CorpData Scientist - Clinical Informatics (Analytics Enablement)NY$79,310–$158,620 / yearA&BC leverages advanced analytics, clinical informatics, and hypothesis-driven approaches to transform data into actionable, customer-centric insights that drive growth, improve health outcomes, and expand access to healthcare across all CVS Health businesses. Experience designing patient-centric data models, feature stores, and dashboards that aggregate longitudinal data across sources, including demographics, encounters, conditions, medications, labs, utilization, cost, and enrichment attributes.
Manager, Salesforce Marketing Cloud Team Lead L'Oreal USA IncManager, Salesforce Marketing Cloud Team LeadNew York, NY$98,400–$140,200 / yearA core dimension of this role is the coordination with business stakeholders across country and zone teams - gathering marketing requirements, translating local business needs into platform solutions, and ensuring the central SFMC team delivers in close alignment with market realities. At L'Oréal, our IT teams design and build solutions to ensure high performance for all our business sectors by imagining new ways of doing things, from designing websites to building algorithms and predicting new trends.
DRG Coding Auditor - MS-DRG and APR-DRG Elevance Health IncDRG Coding Auditor - MS-DRG and APR-DRGNew York, NY$92,880–$160,218 / yearRequires at least one of the following certifications: RHIA certification as a Registered Health Information Administrator, RHIT certification as a Registered Health Information Technician, CCS as a Cert Coding Specialist, CIC as a Certified Inpatient Coder, or Certified Clinical Documentation Specialist (CCDS). Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement policies, billing validation criteria and coding terminology preferred.
Lead Software Engineer StratAcuity Staffing Partners IncLead Software EngineerNew York, NY$120,900–$187,000 / yearIn terms of professional development, Everforth Apex hosts an on-demand training program, provides access to certification prep and a library of technical and leadership courses/books/seminars once you have 6+ months of tenure, and certification discounts and other perks to associations that include CompTIA and IIBA. Everforth Apex also offers a HSA (Health Savings Account on the HDHP plan), a SupportLinc Employee Assistance Program (EAP) with up to 8 free counseling sessions, a corporate discount savings program and other discounts.
AR Follow-Up Specialist III - Coding and Complex Denials #Full Time #Remote 61st Street Service CorpAR Follow-Up Specialist III - Coding and Complex Denials #Full Time #RemoteFort Lee, NJRemote$28.72–$36.92 / hourThe AR Follow-Up Specialist III, Coding and Complex Denials is responsible for addressing and resolving complex coding-related denials and appeals in addition to following up on unpaid accounts with insurance companies and third parties. The Specialist III assists the unit supervisor and manager with complex cases, supports training efforts, and identifies denial trends to inform process improvements.
Staff Engineer - Agentic AI Republic Services IncStaff Engineer - Agentic AINY$132,600–$182,250 / yearUnderstanding of LLMOps/AI DevOps practices (CI/CD for prompts and agents, eval-driven development, prompt and model versioning, observability/tracing, cost and token monitoring, automated red-teaming and guardrail enforcement) to ensure reliable and maintainable GenAI systems. Republic has partnered with renewable gas developers to construct Renewable Natural Gas (RNG) plants at our landfills, expanding beyond the 77 projects we currently have to make progress towards our goal to beneficially reuse 50% more biogas by 2030 (2017 baseline year).
Clinical Data Coordinator - ICD10/CPT Coding - Full Time NewYork-PresbyterianClinical Data Coordinator - ICD10/CPT Coding - Full TimeNew York, NY$109,100–$130,000 / yearProvide expertise in the areas of coding and classification systems to healthcare providers throughout our hospital, with a focus on Inpatient and Ambulatory Surgery, and help drive improvements in documentation, reimbursement and the revenue cycle. At NewYork-Presbyterian, our multi-campus team of HIM professionals is behind every world-renowned patient treatment, surgery and procedure.
Lead - Healthcare - Coding Quality Auditor Sutherland GlobalLead - Healthcare - Coding Quality AuditorClifton, NJThis role evaluates coding accuracy, identifies documentation deficiencies, conducts audits, provides education to coding staff and providers, and supports revenue cycle integrity while minimizing compliance risk. The Medical Coding Auditor is responsible for keeping Sutherland coders in compliance by reviewing medical records and coding practices to ensure accurate assignment of ICD-10-CM, CPT, and HCPCS Level II codes in compliance with federal, state, payer, and organizational guidelines.
Lead Full Stack Developer with Code Modernization & GitHub Copilot - 100% Remote The Dignify Solutions, LLCLead Full Stack Developer with Code Modernization & GitHub Copilot - 100% RemoteJersey City, NJRemoteThe candidate will be responsible for modernizing legacy applications, driving engineering best practices, leveraging Al-powered development tools to improve productivity, and leading end-to- end full-stack development efforts. The ideal candidate should have strong expertise in Code Modernization, Al-assisted development tools such as GitHub Copilot, and experience leading development teams through large-scale digital transformation initiatives.
Software Engineer II, Ad Code - Ad Audience RaptiveSoftware Engineer II, Ad Code - Ad AudienceNew York, New York$120,000–$180,000 / yearRaptive combines its position as the world’s largest ad management platform with a comprehensive suite of monetization, audience and business solutions that enable creators to turn their passions and talents into thriving independent companies and enduring brands. Ability to independently deliver moderately complex work that spans multiple components, while identifying risks and communicating clearly.
Senior Code Specialist 2 (DSO) Metropolitan Transportation AuthoritySenior Code Specialist 2 (DSO)New York, NY$84,893–$106,117 / yearAs part of the Metropolitan Transportation Authority, the largest transportation network in North America, C&D plays a key role in modernizing and expanding services that support 15.3 million residents across New York City, Long Island, southeastern New York State, and Connecticut. Pursuant to the New York State Public Officers Law & the MTA Code of Ethics, all employees who hold a policymaking position must file an Annual Statement of Financial Disclosure (FDS) with the NYS Commission on Ethics and Lobbying in Government (the "Commission").
Chinese Speaking Medical Biller NY Otolaryngology PLLCChinese Speaking Medical BillerFlushing, NYFull timeAs a Medical Biller, you will be working closely with patients to answer questions related to billing, processing all forms needed for insurance billing purposes, and collecting necessary documentation from patients. You will also assist and follow-up inquiries to patients, communicate with physicians' offices and hospitals to obtain records, and accurately record patient information.
Denials Coordinator - Hospital Billing Patient Financial Services - Corporate 42nd Street - Full-Time - Days Mount Sinai Health SystemDenials Coordinator - Hospital Billing Patient Financial Services - Corporate 42nd Street - Full-Time - DaysNew York, NY$65,885–$98,827 / yearKey responsibilities include analyzing claim denial reasons, identifying denial trends, sharing trends and findings with owner areas, coordinating the appeals process, collaborating with departments to prevent future denials, maintaining documentation including issue logs with updates, denied dollars and resolutions, and acting as a resource for staff regarding denial-related issues and payer rules. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time - discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it.