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.
Medical Billing Specialist Integrated Health Administrative ServicesMedical Billing SpecialistMamaroneck, New YorkIn this position you are responsible for both administrative functions, client relations and billing processes and will work with the team to ensure the revenue cycle is handled effectively and efficiently. Investigate, correct and resubmit claim denials from third-party payers to ensure billing and coding accuracy.
ProFee Audit Specialist- PRN Datavant LLCProFee Audit Specialist- PRNNYRemote$35–$45 / hourWhat We're Looking For: As 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. 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.
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.
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.
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.
NewMgr - 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.
DRG Reviewer MachinifyDRG ReviewerNY$90,000–$115,000 / yearAs part of the Complex Payment Solutions Team, you will, as a DRG Reviewer, be a key contributor responsible for conducting thorough DRG payment validation reviews, including clinical and coding assessments, of medical records and related documentation in accordance with contract-specific review criteria. Qualifications: Inpatient claims auditing, quality assurance or recovery auditing experience of 2 years or more required, and/or Inpatient Clinical Documentation Integrity experience of 2 years or more required.
DRG QA and Trainer MachinifyDRG QA and TrainerNY$85,000–$95,000 / yearThis position plays a key role in auditing the work of both new hires and current staff while conducting training to ensure team members are equipped with the knowledge and skills needed to succeed. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise.
Dentist ( Pediatric Experience Required) - Exams Only - Queens PDS Management Services, LLCDentist ( Pediatric Experience Required) - Exams Only - QueensQueens, NY$4,000–$10,000 / hourPart timeWe offer a comprehensive range of services, including:Pediatric DentistryOrthodonticsLaser SurgeryConscious SedationOutpatient CareWe also provide specialized training programs to help you enhance your expertise and grow your career within our innovative organization. PDS Management Services is seeking skilled Pediatric Dentists or General Dentists with Pediatric Experience to provide exceptional oral healthcare to children at our Queens, NY location.
Medical Biller Specialist I Urban Health Plan IncMedical Biller Specialist IBronx, NYRemoteAbout Urban Health Plan: At Urban Health Plan (UHP) our mission is to continuously improve the health of communities and the quality of life of the people we serve by providing affordable, comprehensive, quality, primary and specialty health care and by assuring the performance and advancement of innovative best practices. The Billing Specialist will review medical documentation to property bill services and treatment provided and submit claims to the payers following ICD-10, CPT coding and insurance guidelines.
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.
Clinical Research Scientist NovoCure LtdClinical Research ScientistNY$125,000–$185,000 / yearBeyond contributing to protocol development, clinical strategy, and data interpretation, youll build meaningful partnerships with investigators, participate in study-related site activities, and help ensure the successful execution of clinical trials from concept through completion. Working at the intersection of science and operations, youll collaborate with cross-functional teams across Clinical Development, Clinical Operations, Medical Affairs, Data Management, Regulatory Affairs, Safety, and Device Support Specialists.
Software Engineer III Kora/Support Cedar Cares IncSoftware Engineer III Kora/SupportNY$170,000–$215,000 / yearDiversity initiatives that encourage Cedarians to bring their whole selves to work, including three employee resource groups: be@cedar (for BIPOC-identifying Cedarians and their allies), Pridecones (for LGBTQIA+ Cedarians and their allies) and Cedar Women+ (for female-identifying Cedarians). The challenge is only getting worse, as high deductible health plans are the fastest growing plan design in the U.S. Cedar's mission is to leverage data science, smart product design and personalization to make healthcare more affordable and accessible.
NewManager, Data Mining - Payment Integrity Oscar HealthManager, Data Mining - Payment IntegrityNew York, New York$111,780–$146,711 / yearThe 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.
NewManager, 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.
Revenue Cycle Manager, Manhattan NYU Langone HealthRevenue Cycle Manager, ManhattanNew York, NY$84,577.92–$108,000Full timeDemonstrates a significant level of expertise in subject matter to assist and mentor entry-level billing staff, support the operations lead/supervisor in managing day-to-day team activities against scope and timeline, and ensure timely reporting of activities. Analyzes/audits notes and ensure the appropriate codes are charged in order to maintain billing compliance and prevent denials or works with appropriately credentialed staff to perform reviews.