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• Job Type: Officer of Administration, • Regular/Temporary: Regular, • Hours Per Week: 35, • Standard Work Schedule: Monday-Friday, • Building: Parker Plaza, NJ The Revenue Cycle Optimization Manager is responsible for supporting the revenue cycle across all clinical departments achieving maximum efficiency and performance. Responsibilities include analytical reporting, facilitating best practices, identifying issues, and executing plans for revenue cycle improvement. Responsibilities Operations (60%) • Under direction of the Associate Director, the Revenue Cycle Optimization Manager will make recommendations in all aspects of revenue cycle by analyzing data, trends, opportunities and strategies to improve revenue cycle performance., • Develops and implements optimization improvement plans and utilizes a data driven methodology to monitor progress., • Utilizes dashboards and reports to monitor key performance indicators of operational workflows., • Perform disciplined charging, billing and denial analysis to maximize collections, improve workflows and prevent billing errors., • Identify positive and negative revenue cycle trends to determine root causes and corrective solutions to minimize denials., • Identify and deploy standardized solutions and best practices for solving operational issues., • Ensures strategic alignment of optimization plans supporting organizational mission, vision and goals., • Meet with Clinical Department leadership to review and discuss revenue cycle scorecards & dashboards; track and monitor key performance indicators to ensure targets are achieved., • Lead committees, task forces, and/or revenue cycle workgroups., • Develops and maintains excellent working relationships with Columbia University Departments, payers and vendors., • Promotes a culture of collaboration facilitating continuous process improvement and professional development., • Provides direct end user support for revenue cycle improvement and education., • Keeps apprised of rules and regulations affecting revenue cycle. Stays current through appropriate journals and personal contacts of such developments in the industry. Please note: While this position is primarily remote, candidates must be in a Columbia University-approved telework state. There may be occasional requirements to visit the office for meetings or other business needs. Travel and accommodation costs associated with these visits will be the responsibility of the employee and will not be reimbursed by the company. Minimum Qualifications • Bachelor's degree., • Minimum of 4 years related experience and/or a combination of training and revenue cycle experience., • An equivalent combination of education and experience may be considered., • Demonstrated skills in A/R management, problem assessment, and resolution, and collaborative problem solving in complex, interdisciplinary settings., • Ability to work collaboratively with a culturally diverse staff and patient/family population, strong customer service skills, demonstrating tact and sensitivity in stressful situations., • Demonstrated ability process qualitative or quantitative data and draw insightful conclusions., • Excellent oral and written communication skills; must be able to create and deliver high-level communication presentations for senior leadership and organizational stakeholders., • Master's Degree preferred., • Epic experience and certification are preferred., • Prior supervisory experience is preferred., • Knowledge of Epic billing system, Experian, Cognos, PowerBI, Microsoft Applications., • Knowledge of electronic billing systems: front-end and back-end functions. Core Competencies Accountability & Self-Management Level 3 - Intermediate Adaptability to Change Level 3 - Intermediate Communication Level 3 - Intermediate Customer Service-Patient Focus Level 3 - Intermediate Emotional Intelligence Level 3 - Intermediate Problem Solving & Decision Making Level 3 - Intermediate Productivity & Time Management Level 3 - Intermediate Teamwork & Collaboration Level 3 - Intermediate Quality & Compliance Focused Level 3 - Intermediate Leadership Competencies Business Acumen & Vision Driver Level 1 - Introductory Performance Management Level 2 - Basic Innovation & Organizational Development Level 1 - Introductory Equal Opportunity Employer / Disability / Veteran Columbia University is committed to the hiring of qualified local residents.

Certified Professional Coder (CPC) credential is a plus.

Certified Coding Specialist Certification (CCS) or Certified Coding Specialist- Physician-based (CCS-P) or Certified Professional Coder (CPC), Certified Outpatient Coding (COC) preferred.

Job Description Datavant is the data collaboration platform trusted for healthcare. 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. From fulfilling a single patient's request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you're stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. As an Inpatient 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. In this role, you will offer meaningful information tailored to exceed customer expectations, actively identifying and presenting solutions for customer issues. This role is fully remote with a flexible schedule, allowing you to help shape the future of healthcare from your own workspace! Seeking: PRN IP Audit Specialist 3+years' experience. Experience with Streamline evaluator, Cerner, 3/m a plus. Will be responsible for onboarding and monthly IP coding QA; CCS certification. You Will: • Conduct inpatient coding audits on medical records, utilizing ICD-10-CM, CPT, and appropriate coding references for accurate DRG and APC assignment., • Review non-CC/MCC records to assess proper coding or identify the need for additional documentation. Scrutinizes all HCPCS and CPT codes influencing APC assignment., • Provide coder education through the auditing process., • Prepare preliminary results for review by the facility or CCS HIM director., • Review disagreements on APC/DRG changes with the appropriate manager., • Prepare the final reports for the coding audit and actively participates in the resolution of audit findings., • Provide coder education via email and/or conference calls, utilizing the audit spreadsheet findings and comments., • Attend coding workshops as necessary., • Stay current with regulatory changes., • Organize and prioritize multiple cases concurrently to ensure departmental workflow and prompt case resolution., • Demonstrate versatility and exceptional work across a wide range of coded services., • Meet with client facility representatives to discuss issues and trends identified in audits., • Develop and implement education for physicians, nursing, and other clinical staff to enhance documentation., • Communicate effectively with co-workers, management, and hospital staff regarding clinical and reimbursement issues., • Function in a professional, efficient, and positive manner., • Adhere to the American Health Information Management Association's code of ethics., • Maintain a customer-service focus and exhibits professionalism, flexibility, dependability, a desire to learn, commitment to excellence, and commitment to the profession., • Conduct audits on external coding staff as needed and provides reports to the manager as directed., • Handle a high complexity of work functions and decision-making. What you will bring to the table: • 3+ years experience coding and auditing, • Associate or Bachelor's degree from an AHIMA-certified HIM or Nursing Program, or completion of a certificate program from AAPC with a preference for CCS, • Preferred: CCS, RHIT, or RHIA credentials., • Recent experience in academic/level 1 trauma centers, • Experience coding and auditing inpatient and outpatient records for various facilities, • Track record of acceptable productivity standards, • Maintain 95% accuracy rate for APC assignment and 95% productivity rate, • Experience with various software including EMR, Encoder and Auditing software Perks: • Benefits for Full-Time employees: Medical, Dental, Vision, 401k Savings Plan w/match, 2 weeks of paid time off, and Paid Holidays, Floating Holidays, • Free CEUs every year, • Stipend provided to assist with education and professional dues (AHIMA/AAPC) If Applicable, • Equipment: monitor, laptop, mouse, headset, and keyboard, • Comprehensive training led by a credentialed professional coding manager, • Exceptional service-style management and mentorship (we're in this together!) We are all responsible for stewarding a high-performance culture in which all Datavanters belong and thrive. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. Our compensation philosophy is to be externally competitive, internally fair, and not win or lose on compensation. Salary ranges for this position are developed with the support of benchmarks (competitive San Francisco rates for US-based roles) and industry best practices. We're building a high-growth, high-autonomy culture. We rely less on job titles and more on cultivating an environment where anyone can contribute, the best ideas win, and personal growth is driven by expanding impact. This means we default to simple job titles (e.g., Software Engineer) rather than complex ones (e.g., Senior Software Engineer). Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role. 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. Any requests to be exempted from these requirements will be reviewed by Datavant Human Resources and determined on a case-by-case basis. Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion. This job is not eligible for employment sponsorship. Datavant is committed to a work environment free from job discrimination. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. To learn more about our commitment, please review our EEO Commitment Statement here. Know Your Rights, explore the resources available through the EEOC for more information regarding your legal rights and protections. In addition, Datavant does not and will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay. At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your answers will be anonymous and will help us identify areas for improvement in our recruitment process. (We can only see aggregate responses, not individual ones. In fact, we aren't even able to see whether you've responded.) Responding is entirely optional and will not affect your application or hiring process in any way. Datavant is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need an accommodation while seeking employment, please request it here, by selecting the 'Interview Accommodation Request' category. You will need your requisition ID when submitting your request, you can find instructions for locating it here. Requests for reasonable accommodations will be reviewed on a case-by-case basis. For more information about how we collect and use your data, please review our Privacy Policy.

Job Description Datavant is the data collaboration platform trusted for healthcare. 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. From fulfilling a single patient's request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you're stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. We're looking for experienced and credentialed outpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing you to help shape the future of healthcare from your own workspace! Preferred: Facility Outpatient Coder with a specialization in claim edits and denials. Qualified candidates will have 3+ years of coding experience, experience with multispecialty coding, and the ability to consistently meet performance standards. Proficiency with Microsoft applications and the ability to navigate multiple facility systems. *** What You Will Do: • Review medical records and assign accurate codes for diagnoses and procedures., • Assign and sequence codes accurately based on medical record documentation., • Assign the appropriate discharge disposition., • Abstract and enter the coded data for hospital statistical and reporting requirements., • Communicate documentation improvement opportunities and coding issues to appropriate personnel for follow up and resolution., • Maintain a 95% coding accuracy rate and a 95% accuracy rate for APC assignment and meet site-designated productivity standards., • Be responsible for tracking continuing education credits to maintain professional credentials., • Attend Datavant Health sponsored education meetings/in-services., • Demonstrate initiative and judgment in the performance of job responsibilities., • Communicate with co-workers, management, and hospital staff regarding clinical and reimbursement issues., • Function in a professional, efficient, and positive manner., • Adhere to the American Health Information Management Association's code of ethics., • Be customer-service focused and exhibit professionalism, flexibility, dependability, and a desire to learn., • Handle a high complexity of work function and decision-making., • Possess strong organizational and teamwork skills. What You Need to Succeed: • AHIMA certified credentials (RHIA, RHIT, CCS) or AAPC certified credentials (CPC, CPC-H, COC, CIC or CRC)., • 2+ years of coding experience in a hospital and/or coding consulting role., • Proficiency with most or all of these coding specialties (Same Day Surgery, Observation, Injections/Infusions), • Proficiency with most or all of these coding specialties (Ancillary, Emergency Department, Injections/Infusions, E/M leveling), • Strong written and verbal communication skills, adeptness in remote work, and exceptional time management skills., • Experience in computerized encoding and abstracting software., • Required to take and pass annual Introductory HIPAA examination and other assigned testing to be given annually, • Experience in computerized encoding and abstracting software What We Offer: • Benefits for Full-Time employees: Medical, Dental, Vision, 401k Savings Plan w/match, 2 weeks of paid time off, and Paid Holidays, Floating Holidays, • Benefits for PRN employees: 401k savings plan w/match, • Free CEUs every year, • Stipend provided to assist with education and professional dues (AHIMA/AAPC), • Equipment: monitor, laptop, mouse, headset, and keyboard, • Comprehensive training led by a credentialed professional coding manager, • Exceptional service-style management and mentorship (we're in this together!) Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role. The estimated base pay range per hour for this role is:$20—$35 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. Any requests to be exempted from these requirements will be reviewed by Datavant Human Resources and determined on a case-by-case basis. Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion. This job is not eligible for employment sponsorship. Datavant is committed to a work environment free from job discrimination. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. To learn more about our commitment, please review our EEO Commitment Statement here. Know Your Rights, explore the resources available through the EEOC for more information regarding your legal rights and protections. In addition, Datavant does not and will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay. At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your answers will be anonymous and will help us identify areas for improvement in our recruitment process. (We can only see aggregate responses, not individual ones. In fact, we aren't even able to see whether you've responded.) Responding is entirely optional and will not affect your application or hiring process in any way. Datavant is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need an accommodation while seeking employment, please request it here, by selecting the 'Interview Accommodation Request' category. You will need your requisition ID when submitting your request, you can find instructions for locating it here. Requests for reasonable accommodations will be reviewed on a case-by-case basis. For more information about how we collect and use your data, please review our Privacy Policy.

Job Description Hi, we're Oscar. We're hiring a SIU Coding Auditor to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role The Senior Specialist works in the Special Investigation Unit to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to prevent and recoup inappropriately paid claims. The Specialist Investigation Unit runs and coordinates activities across Oscar to reduce the incidence and impact of fraud, waste, and/or abuse ("FWA") on all our operations. You will report to the Manager, SIU Coding Audit. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois; Iowa; Kansas; Michigan; Missouri; Nebraska; New Jersey; North Carolina; Ohio; Oklahoma; Pennsylvania; South Carolina; Tennessee; Texas; or Virginia. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. Pay Transparency: The base pay for this role in the states of New Jersey and New York is: $65,412 - $85,853 per year. The base pay for this role is: $58,870 - $77,267 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities • Develop a depth of expertise on CPT, HCPCS, and ICD-10 Coding guidelines and other insurance billing submission requirements., • Perform complex audits of assigned medical records and claims on both a prepayment and post payment basis to determine accuracy of claims submitted to Oscar., • Document findings including reference to sources used to support decision making and in a way that can be easily understood by non clinicians or coders., • Create audit report findings, tools, and reference guide that can be used by other team members to communicate findings or more effectively perform similar reviews., • Help draft written communications to providers to convey audit findings., • Participate in educational calls with providers., • Help train new team members., • Develop and document processes to improve the effectiveness of the team., • Compliance with all applicable laws and regulations, • Other duties as assignedQualifications, • 2+ years of coding or auditing experience across multiple specialties is required, • Bachelor's degree or 4+ years of work experience, • Certified Professional Coder (CPC), Certified Inpatient Coder (CIC), Certified Outpatient Coder (COC) designation or similar certification, • Experience working in production-based environment, • Experience of both outpatient and inpatient auditingBonus Points, • Certified Professional Medical Auditor (CPMA), • Additional certification applicable to this work such as Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), Certified AML [Anti-Money Laundering] and Fraud Professional (CAFP), other coding certifications or similar, • Knowledge of applicable fraud statutes and regulations, and of federal guidelines on recoupments and other anti-FWA activity, • Demonstrated experience translating technical jargon to non-technical end users., • Experience working in health insurance specifically with claims processing, billing, reimbursement, or provider contracting., • Experience with HIPAA, data privacy, and/or data security processes At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team () to make the need for an accommodation known. California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

Identify potential documentation and coding errors by recognizing aberrant coding and documentation patterns such as inappropriate billing for readmissions, inpatient admission status, and Hospital-Acquired Conditions (HACs). AAPC CPC (AAPC Certified Professional Coder) & AAPC CIC (Certified Inpatie

Job Description Datavant is the data collaboration platform trusted for healthcare. 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. From fulfilling a single patient's request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you're stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. As an Inpatient 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. In this role, you will offer meaningful information tailored to exceed customer expectations, actively identifying and presenting solutions for customer issues. This role is fully remote with a flexible schedule, allowing you to help shape the future of healthcare from your own workspace! * You Will: • Conduct inpatient coding audits on medical records, utilizing ICD-10-CM, CPT, and appropriate coding references for accurate DRG and APC assignment., • Review non-CC/MCC records to assess proper coding or identify the need for additional documentation. Scrutinizes all HCPCS and CPT codes influencing APC assignment., • Provide coder education through the auditing process., • Prepare preliminary results for review by the facility or CCS HIM director., • Review disagreements on APC/DRG changes with the appropriate manager., • Prepare the final reports for the coding audit and actively participates in the resolution of audit findings., • Provide coder education via email and/or conference calls, utilizing the audit spreadsheet findings and comments., • Attend coding workshops as necessary., • Stay current with regulatory changes., • Organize and prioritize multiple cases concurrently to ensure departmental workflow and prompt case resolution., • Demonstrate versatility and exceptional work across a wide range of coded services., • Meet with client facility representatives to discuss issues and trends identified in audits., • Develop and implement education for physicians, nursing, and other clinical staff to enhance documentation., • Communicate effectively with co-workers, management, and hospital staff regarding clinical and reimbursement issues., • Function in a professional, efficient, and positive manner., • Adhere to the American Health Information Management Association's code of ethics., • Maintain a customer-service focus and exhibits professionalism, flexibility, dependability, a desire to learn, commitment to excellence, and commitment to the profession., • Conduct audits on external coding staff as needed and provides reports to the manager as directed., • Handle a high complexity of work functions and decision-making. What you will bring to the table: • 3+ years experience coding and auditing, • Associate or Bachelor's degree from an AHIMA-certified HIM or Nursing Program, or completion of a certificate program from AAPC with a preference for CCS, • Preferred: CCS, RHIT, or RHIA credentials., • Recent experience in academic/level 1 trauma centers, • Experience coding and auditing inpatient and outpatient records for various facilities, • Track record of acceptable productivity standards, • Maintain 95% accuracy rate for APC assignment and 95% productivity rate, • Experience with various software including EMR, Encoder and Auditing software Perks: • Benefits for Full-Time employees: Medical, Dental, Vision, 401k Savings Plan w/match, 2 weeks of paid time off, and Paid Holidays, Floating Holidays, • Free CEUs every year, • Stipend provided to assist with education and professional dues (AHIMA/AAPC) If Applicable, • Equipment: monitor, laptop, mouse, headset, and keyboard, • Comprehensive training led by a credentialed professional coding manager, • Exceptional service-style management and mentorship (we're in this together!) We are all responsible for stewarding a high-performance culture in which all Datavanters belong and thrive. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. Our compensation philosophy is to be externally competitive, internally fair, and not win or lose on compensation. Salary ranges for this position are developed with the support of benchmarks (competitive San Francisco rates for US-based roles) and industry best practices. We're building a high-growth, high-autonomy culture. We rely less on job titles and more on cultivating an environment where anyone can contribute, the best ideas win, and personal growth is driven by expanding impact. This means we default to simple job titles (e.g., Software Engineer) rather than complex ones (e.g., Senior Software Engineer). Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role. 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. Any requests to be exempted from these requirements will be reviewed by Datavant Human Resources and determined on a case-by-case basis. Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion. This job is not eligible for employment sponsorship. Datavant is committed to a work environment free from job discrimination. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. To learn more about our commitment, please review our EEO Commitment Statement here. Know Your Rights, explore the resources available through the EEOC for more information regarding your legal rights and protections. In addition, Datavant does not and will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay. At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your answers will be anonymous and will help us identify areas for improvement in our recruitment process. (We can only see aggregate responses, not individual ones. In fact, we aren't even able to see whether you've responded.) Responding is entirely optional and will not affect your application or hiring process in any way. Datavant is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need an accommodation while seeking employment, please request it here, by selecting the 'Interview Accommodation Request' category. You will need your requisition ID when submitting your request, you can find instructions for locating it here. Requests for reasonable accommodations will be reviewed on a case-by-case basis. For more information about how we collect and use your data, please review our Privacy Policy.

Job Description Hi, we're Oscar. We're hiring a SIU Investigator to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role: The SIU Investigator identifies and investigates aberrant behavior observed in medical claims data and member enrollment data. You will manage an investigative caseload from case identification through to resolution, including data mining, investigation planning, data analysis, sampling, medical records requests, audit interpretation, overpayment recovery, reporting to regulatory agencies and monitoring ongoing provider behavior. The Senior Analyst will meet metrics set forth related to caseload, turn around times, and other unit-wide goals. You will report into the Investigations Manager, SIU. Work Location: This is a remote position, open to candidates who reside in: Arizona, Florida, Georgia, Illinois, Iowa, Kansas, Michigan, Missouri, Nebraska, New Jersey, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas and Virginia. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. If you live within commutable distance to our New York City office (in Hudson Square) or our Tempe office (off the 101 at University Ave), you will be expected to come into the office at least three days each week. Otherwise, this is a remote / work-from-home role. Thursdays are a required in-office day for team meetings and events, while your other two office days are flexible to suit your schedule. The base pay for this role in the states of New Jersey and New York is: $72,036 - $94,546 per year. The base pay for this role in all other locations is: $64,832 - $85,092 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: • Identify and conduct investigations into suspected FWA with high autonomy, • Document findings to include formal investigative reports, tables, graphs, audit logs, and other supporting documentation, • Met metrics to align with caseload, turn around times, and other unit-wide goals, • Continue to monitor providers with substantiated findings to track behavior change, • Participate in the development and presentation of FWA-related education for Oscar teams, • Build evidentiary files for potential recovery, legal action, and/or referrals to appropriate outside agencies, • Compliance with all applicable laws and regulations, • 3+ years of healthcare fraud investigation experience or professional investigation experience with law enforcement agencies, • Bachelor's degree in Criminal Justice or a related field, • Experience with HIPAA, data privacy, and/or data security processes, • Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), Certified AML [Anti-Money Laundering] and Fraud Professional (CAFP), or similar At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team () to make the need for an accommodation known. California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

Job Description Datavant is the data collaboration platform trusted for healthcare. 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. From fulfilling a single patient's request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you're stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. 2,500 Sign on Bonus* As an Inpatient 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. In this role, you will offer meaningful information tailored to exceed customer expectations, actively identifying and presenting solutions for customer issues. This role is fully remote with a flexible schedule, allowing you to help shape the future of healthcare from your own workspace! Preferred: In need for a FT IP auditing specialist. Auditing specialist will be responsible for reviewing and validating DRGs specific to Medicare and Medicare Managed Care. Interest in coding IP charts in the event the contract ends. Must be able to work 40 hours/week M-F. Systems: Cerner PowerChart, 3M360; CCS certification. You Will: • Conduct inpatient coding audits on medical records, utilizing ICD-10-CM, CPT, and appropriate coding references for accurate DRG and APC assignment., • Review non-CC/MCC records to assess proper coding or identify the need for additional documentation. Scrutinizes all HCPCS and CPT codes influencing APC assignment., • Provide coder education through the auditing process., • Prepare preliminary results for review by the facility or CCS HIM director., • Review disagreements on APC/DRG changes with the appropriate manager., • Prepare the final reports for the coding audit and actively participates in the resolution of audit findings., • Provide coder education via email and/or conference calls, utilizing the audit spreadsheet findings and comments., • Attend coding workshops as necessary., • Stay current with regulatory changes., • Organize and prioritize multiple cases concurrently to ensure departmental workflow and prompt case resolution., • Demonstrate versatility and exceptional work across a wide range of coded services., • Meet with client facility representatives to discuss issues and trends identified in audits., • Develop and implement education for physicians, nursing, and other clinical staff to enhance documentation., • Communicate effectively with co-workers, management, and hospital staff regarding clinical and reimbursement issues., • Function in a professional, efficient, and positive manner., • Adhere to the American Health Information Management Association's code of ethics., • Maintain a customer-service focus and exhibits professionalism, flexibility, dependability, a desire to learn, commitment to excellence, and commitment to the profession., • Conduct audits on external coding staff as needed and provides reports to the manager as directed., • Handle a high complexity of work functions and decision-making. What you will bring to the table: • 3+ years experience coding and auditing, • Associate or Bachelor's degree from an AHIMA-certified HIM or Nursing Program, or completion of a certificate program from AAPC with a preference for CCS, • Preferred: CCS, RHIT, or RHIA credentials., • Recent experience in academic/level 1 trauma centers, • Experience coding and auditing inpatient and outpatient records for various facilities, • Track record of acceptable productivity standards, • Maintain 95% accuracy rate for APC assignment and 95% productivity rate, • Experience with various software including EMR, Encoder and Auditing software Perks: • Benefits for Full-Time employees: Medical, Dental, Vision, 401k Savings Plan w/match, 2 weeks of paid time off, and Paid Holidays, Floating Holidays, • Free CEUs every year, • Stipend provided to assist with education and professional dues (AHIMA/AAPC) If Applicable, • Equipment: monitor, laptop, mouse, headset, and keyboard, • Comprehensive training led by a credentialed professional coding manager, • Exceptional service-style management and mentorship (we're in this together!) We are all responsible for stewarding a high-performance culture in which all Datavanters belong and thrive. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. Our compensation philosophy is to be externally competitive, internally fair, and not win or lose on compensation. Salary ranges for this position are developed with the support of benchmarks (competitive San Francisco rates for US-based roles) and industry best practices. We're building a high-growth, high-autonomy culture. We rely less on job titles and more on cultivating an environment where anyone can contribute, the best ideas win, and personal growth is driven by expanding impact. This means we default to simple job titles (e.g., Software Engineer) rather than complex ones (e.g., Senior Software Engineer). The range posted is for a given job title, which can include multiple levels. Individual rates for the same job title may differ based on level, responsibilities, skills, and experience for a specific job. Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role. 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. Any requests to be exempted from these requirements will be reviewed by Datavant Human Resources and determined on a case-by-case basis. Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion. This job is not eligible for employment sponsorship. Datavant is committed to a work environment free from job discrimination. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. To learn more about our commitment, please review our EEO Commitment Statement here. Know Your Rights, explore the resources available through the EEOC for more information regarding your legal rights and protections. In addition, Datavant does not and will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay. At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your answers will be anonymous and will help us identify areas for improvement in our recruitment process. (We can only see aggregate responses, not individual ones. In fact, we aren't even able to see whether you've responded.) Responding is entirely optional and will not affect your application or hiring process in any way. Datavant is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need an accommodation while seeking employment, please request it here, by selecting the 'Interview Accommodation Request' category. You will need your requisition ID when submitting your request, you can find instructions for locating it here. Requests for reasonable accommodations will be reviewed on a case-by-case basis. For more information about how we collect and use your data, please review our Privacy Policy.

Job DescriptionDescription: We are seeking a detail-oriented and experienced Billing and Coding Specialist to join our healthcare team. This role is vital in ensuring accurate and timely processing of medical claims, supporting our commitment to efficient patient care and revenue cycle management. If you have a strong understanding of medical billing and coding procedures, we invite you to become a key part of our organization’s success. Key Responsibilities: • Review and accurately code medical diagnoses, procedures, and services using ICD-10, CPT, and HCPCS coding systems., • Prepare and submit insurance claims in a timely manner, ensuring compliance with payer requirements., • Verify patient insurance coverage and obtain necessary authorizations., • Follow up on unpaid or denied claims to facilitate prompt resolution., • Maintain detailed and organized records of billing and coding activities., • Stay updated on changes in coding regulations and insurance policies., • Collaborate with healthcare providers and administrative staff to resolve billing issues., • Ensure compliance with all relevant healthcare laws and regulations. Benefits Available: • Multiple medical and prescription coverage options, • Dental and vision care plans, • Health Savings Accounts (HSAs), where applicable, • Flexible Spending Accounts (FSAs), • Voluntary critical illness, cancer, and accident insurance, • Voluntary hospital indemnity coverage, • Voluntary short-term and long-term disability insurance, • Voluntary term life insurance and AD&D (Accidental Death & Dismemberment), • 401(k) retirement savings plan, • Paid time off (PTO), • Commuter benefits, • Proven experience in medical billing and coding, preferably in a healthcare setting., • Certification such as Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) is preferred., • Strong knowledge of ICD-10, CPT, HCPCS coding systems, and medical terminology., • Familiarity with electronic health records (EHR) and billing software., • Excellent attention to detail and organizational skills., • Ability to work independently and as part of a team., • Strong communication skills and problem-solving abilities., • Knowledge of healthcare regulations and compliance standards.

MS Word, Excel, ICD 9 CM, CPT 4, Encoder);.

Partners, Associates, and business services professionals.

The ideal candidate will be certified, experienced, and capable of working independently with minimal supervision. Encoder and 3M/HDS applications. Support coder training and knowledge sharing when needed.

Amazing Outpatient Surgery Organization is Looking to Hire a Hybrid Outpatient Medical Coder (Surgical Coding)!. Do you have 3+ years of medical coding experience in an outpatient setting (ideally surgery)? Are you CPC certified?.

Exceptional communication skillsable to explain billing details clearly and professionally.

With a global presence and a team of top-tier professionals, our client fosters an inclusive and dynamic work environment where every team member plays a crucial role in delivering world-class results. As a member of their team, you'll be part of a highly respected organization that prioritizes prof

Accounts Receivable / Billing Specialist.At Honeycomb, we're reshaping the future of insurance.In 2025, Honeycomb was recognized by Dun & Bradstreet as "Top 10 Best Start Up Companies to Work For" in Israel and named by LinkedIn as "Top 10 Startups in Chicago".Honeycomb is a rapidly growing global s

Good Apple is looking for an ambitious self-starter, with great attention to detail to join the team.This position is responsible for the compilation, review, and recording of financial transactions and assisting in the completion of month-end processing.This hands-on billing role reports directly t

Qualified candidates should have at least five years of billing experience in a professional services environment, with experience using billing software such as Elite 3E preferred.

New York Edge is seeking a highly organized, knowledgeable, and focused individual to fill the role of Billing Specialist.In this full-time role, you will be responsible for ensuring that New York Edge timely and accurately bills for a portfolio of government contracts.The Billing Specialist ensures

The Senior Billing Specialist will prepare bills in accordance with client guidelines and partner instructions.They will review time and disbursement records and address compliance issues, collaborate with attorneys, clients and colleagues, and address requests and special projects.Monitor unbilled

LHH is partnering with a well-established media organization in New York City to hire a Billing Specialist on a temp to perm basis.This role is based in a beautiful Midtown Manhattan office and offers a hybrid schedule, providing a strong balance of in-office collaboration and flexibility.This is a

Prestigious NYC based Law Firm seeks a Senior Billing Specialist to join their Team!.Prepare bills in accordance with client guidelines and partner instructions.Review time and disbursement records and address compliance issues, collaborate with attorneys, clients and colleagues, and address request

Pharmacy/Durable Medical Equipment (DME) company is looking for a biller to conduct data entry, billing and collections.Candidate must be proficient with managing all aspects of the medical claims process, and be willing to lead by example.This will involve sharing duties of calling for eligibility

Established prestigious NYC Law Firm seeks an E-Billing Specialist to join their Team!.Responsible for the timely submission of e-bills for a large number of the firm's clients.Submit e-bills to clients utilizing Bill Blast and various e-billing vendors and verifying successful submission.Create new

Excellent written and verbal skills in order to provide professional, efficient customer service functions.

Core duties: Perform billing and invoicing tasks twice a week.Review line items and ensure accuracy.Submit billing data to insurance providers.Proficiency in Excel is a must.Duration: Temporary to permanent.Schedule: Monday to Friday, 8:30 am to 5:00 pm with a 30-minute lunch break.

Cobble Hill is currently hiring an Administrative Specialist (Senior Billing Focus) to join our team! Your Choice At Home is an affiliate of Cobble Hill Life Center and a Certified Home Health Agency (CHHA). This role requires a higher-level billing professional with experience reviewing invoices, s

Establishes, fosters, and maintains professional and collaborative relationships with attorneys, business services personnel, and clients to ensure compliance with both attorney and client specifications; manages all billing processes from engagement to bill posting with tact and diplomacy. Law Firm

Assures the correct processing of billings, disbursements and reconciliations.Specific duties and responsibilities include:.Perform preliminary and final billing to HRA for 819 Residential programs.Post payments from HRA and allocate by program report unit.Keep track HRA overpayment and underpayment

BA/BS degree in Business Administration or related experience, preferably in a large legal services or professional services organization.

Birch Family Services is a leading provider of education, employment, and community support services for individuals with autism and developmental disabilities and their families in New York City.Every year, the organization supports more than 2,000 people across 31 locations in Manhattan, Queens, B

Wisdom blends industry expertise with advanced technology to make dental practices work better for everyone involved.We believe dentistry is about people, and we exist to make the future of dentistry stronger and more sustainable for dentists, their teams, and the patients they serve.We match admini

The actual salary offered will be based on a number of factors including but not limited to the qualifications of the applicant, years of relevant experience, level of education attained, certifications or other professional licenses held, and if applicable, the location in which the applicant lives

This position is available with Upstate HomeCare, a BioMatrix company.BioMatrix is a nationwide, independently-owned infusion pharmacy with decades of experience supporting patients on specialty medication.Our compassionate care team helps patients navigate the often-challenging healthcare environme

Follow up with clients on collections while maintaining professionalism.

Minimum of 5 years in a Billing Coordinator or Specialist role, preferably in a mid to large-size Law Firm or Professional Services Firm.

Insurance Claims Resolution Specialist.Responsible for the timely and accurate resolution of insurance claims, primarily for Medicare, Medicaid, and HMO plans.This role involves follow-up on claims from billing through final resolution, identifying and correcting errors, and ensuring prompt payment

Clear, professional communication skills especially when following up on overdue balances.

LHH Talent - - Responsibilities: Prepare and issue accurate invoices based on project milestones, time tracking, and contractual terms; Monitor accounts receivable and follow up on outstanding payments; Reconcile billing discrepancies and resolve client inquiries promptly; Assist with cash applicat

Brooklyn or Bronx, NY (On-site).The Infusion Billing Specialist is responsible for managing the full revenue cycle for infusion services within a clinical setting.This role requires expertise in medical billing, coding, payer contracts, and prior authorizations specific to infusion therapies.Verify

As a medical coder on our team, you’ll play a vital role ensuring our claims process runs smoothly and efficiently for our customers. Duties & Responsibilities Review health insurance EOBs (Explanation of Benefits) on excess claims to ensure proper payment Ensure AOB (Assignment of Benefits) has b

Must be a Certified Medical Coder, CPC / CPC-A. LaSante Health Center is seeking a detail-oriented in-person Medical Coder to ensure accurate coding and abstraction of patient encounters.

CIRCC certification Plusses: Radiology Certified Coder (RCC) Compensation: $25. Day-to-Day: Insight Global is searching for a contract Pro-Fee Radiology Coder for one of our largest healthcare clients in the Southeast. These coders will be expected to have extensive experience coding on a pro-fee b