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The Marwood Group is a healthcare advisory services firm headquartered in New York City with offices in Washington, DC, and London. The Healthcare Advisory Group advises and consults with the firm’s private equity and corporate clients on healthcare policy, strategy, and market analysis issues. Areas of focus include Medicare, Medicaid, commercial insurance, worker’s compensation, and clinical compliance. Marwood operates at the intersection of Wall Street and Washington, with experienced professionals from top banking, consulting, and healthcare operations firms, as well as senior political and governmental positions. The Advisory Group is currently accepting applications for an outpatient Certified Coding Auditor to work in its New York office or remotely. Principal duties and responsibilities: Perform remote billing and coding audits to ensure client coding practices are compliant with regulations and coverage policies for both government and commercial payors. Researching state and payer regulations to identify areas of risk in a variety of healthcare settings and specialties, coordinating with various team members to ensure clear expectations are communicated and deadlines are met. Qualifications: CPC/CCS-P with a minimum of 5 years of experience in healthcare coding/auditing (E&M, CPT, HCPCS, and ICD-10), with knowledge of professional billing, coding, and documentation practices performed by physicians and other qualified healthcare providers in the outpatient setting. Proficiency in evaluating how well clinical documentation supports medical necessity and the E/M, CPT, and HCPCS codes that were billed, across a wide range of services. Experience in specialties such as primary care, dermatology, vascular, podiatry, wound care, home health, and personal care is preferred. Behavioral health and HCC coding experience is also a plus. Proven ability to identify billing and coding issues including use of modifiers, bundling issues, CCI edits, therapeutic and diagnostic procedures, supplies, materials, injections, drugs, and units of service etc. Solid understanding of both federal and state coding and documentation laws and regulations, applicable fraud statutes, and regulations, and of federal guidelines on recoupments and other anti-FWA activity. Identify and access risk of repayment or recoupment in the event of payor scrutiny. Familiarity with both UB-04 and CMS 1500 claims data, as well as understanding of payor remittances. Knowledge of anatomy, physiology, and medical terminology necessary to appropriately review assignment and documentation of diagnosis codes. Solid working knowledge of various EHR/EMR systems; experience accessing these remotely. Strong organizational skills and task management Highly organized with a high level of attention to detail Ability to work in a fast paced and rapidly changing environment. Skilled at multi-tasking with the ability to handle several different priorities simultaneously. Strong communication skills with experience in articulating audit findings and interpretation of coding regulations Experience with HIPAA, data privacy, and/or data security processes. Experience working with regulators governing (public or private) health insurance carriers. A minimum of AAPC or AHIMA certification required, that could include: • Certified Professional Coder (CPC), • Certified Outpatient Coder (COC™), • Certified Professional Medical Auditor (CPMA), • Certified Risk Adjustment Coder (CRC™), • Certified Coding Specialist (CCS), • Certified Coding Specialist – Physician based (CCS-P) For consideration please email resume and cover letter as attachments with salary expectations to careers22@marwoodgroup.com with the subject title “Certified Coding Auditor.” Marwood offers a comprehensive compensation package with full benefits. We offer a competitive wage, a collaborative work environment and an opportunity to participate in a full benefit package, including, Medical, Dental, Vision, Life, AD&D, Voluntary Life and LTD, Spouse and Dependent Life, 401k Retirement plan with a company match, Commuter, FSA/DCFSA, professional development, and professional certification renewal reimbursement. We offer paid days off, and paid holidays. Marwood prides itself on providing employees with a good work-life balance. There is no travel expected with this position. The position is based in our New York location. Currently working a hybrid schedule. Remote option will be considered. For consideration please email resume and cover letter as attachments with salary expectations to careers22@marwoodgroup.com with the subject title “Certified Coding Auditor.” We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity and or expression, status as a veteran, and basis of disability or any other federal, state, or local protected class.

Job DescriptionJob Description: Medical Coding Author (CCS / CIC / CPC Certified) Role Type: Contractor Location: Remote – United States Only About the Role We are seeking experienced and certified Medical Coding Authors to contribute their expertise to an AI training and evaluation project. In this role, you will create high-quality medical coding scenarios, educational materials, and assessment content to help train next-generation AI systems. Your expertise in real-world medical coding practices will support the development of AI models capable of accurately interpreting clinical documentation and applying complex coding guidelines. No prior AI experience is required; your professional coding knowledge is what matters. Scope of Work • Develop realistic medical coding scenarios, clinical documentation excerpts, and coding questions across inpatient, outpatient, and professional fee settings, including accurate ICD-10-CM, ICD-10-PCS, CPT, and HCPCS code assignments., • Create detailed answer keys and explanations covering code selection, sequencing, modifiers, and Present on Admission (POA) indicators, with references to relevant official guidelines and coding conventions., • Develop evaluation rubrics and test cases of varying complexity, including ambiguous and challenging clinical documentation, to assess AI models' ability to apply medical coding rules accurately., • Review, validate, and revise existing coding content for accuracy, clarity, and alignment with current ICD-10-CM/PCS Official Guidelines, AHA Coding Clinic guidance, and CPT coding standards., • Collaborate with project stakeholders through written and verbal communication to clarify requirements, resolve documentation ambiguities, and maintain data integrity., • Provide detailed feedback on coding guidelines, complex coding cases, and content quality to improve project workflows and strengthen AI model performance.Required Qualifications, • Hold an active AHIMA Certified Coding Specialist (CCS), AAPC Certified Inpatient Coder (CIC), or AAPC Certified Professional Coder (CPC) credential., • Strong knowledge of ICD-10-CM, ICD-10-PCS, and CPT coding systems, supported by hands-on coding experience in a hospital, physician practice, or coding audit environment., • Experience developing or reviewing medical coding content, including training materials, audit findings, coder education resources, or examination preparation materials., • Ability to explain complex coding decisions, code assignments, and guideline interpretations clearly and accurately in writing., • Excellent written and verbal communication skills, with strong attention to detail and accuracy., • Access to current ICD-10-CM, ICD-10-PCS, and CPT code sets, along with the applicable Official Coding Guidelines.Preferred Qualifications, • Experience creating educational content, coding assessments, or technical reference materials for medical coding professionals., • Familiarity with evaluating coding accuracy, identifying documentation gaps, and resolving complex or ambiguous coding scenarios., • Experience with AI training, data annotation, content validation, or model evaluation projects.

Job DescriptionJob Description: Medical Records Coder (CCS / CIC / CPC Certified) Role Type: Contractor Location: Remote – United States Only About the Role We are seeking experienced and certified Medical Records Coders to contribute their expertise to an AI training and evaluation project. In this role, you will use your medical coding knowledge to review, annotate, and validate clinical documentation, helping improve how next-generation AI systems interpret medical records and apply accurate coding standards. Your real-world coding experience will support the development of reliable AI models. No prior AI experience is required; your professional expertise is what matters. Scope of Work • Review and annotate medical records, including encounter notes, progress notes, operative reports, consultation reports, laboratory and imaging results, and discharge summaries, ensuring accurate ICD-10-CM, ICD-10-PCS, CPT, and HCPCS code assignments based on clinical documentation., • Identify principal and secondary diagnoses, sequence codes according to applicable guidelines, and assign modifiers and Present on Admission (POA) indicators where required., • Apply established coding conventions and payer-neutral best practices, including the Official Guidelines for Coding and Reporting and AHA Coding Clinic guidance., • Identify documentation gaps, inconsistencies, and opportunities for provider queries to support accurate and complete coding., • Collaborate with project stakeholders through written and verbal communication to clarify requirements, resolve documentation ambiguities, and maintain data integrity., • Provide expert feedback on coding guidelines and complex cases to improve project workflows and enhance AI model understanding., • Ensure the accuracy, consistency, and completeness of all coding annotations in accordance with current industry standards and best practices.Required Qualifications, • Hold an active AHIMA Certified Coding Specialist (CCS), AAPC Certified Inpatient Coder (CIC), or AAPC Certified Professional Coder (CPC) credential., • Strong knowledge of ICD-10-CM, ICD-10-PCS, and CPT coding systems, supported by hands-on experience coding medical records., • Experience coding across multiple healthcare settings, including acute care, outpatient, emergency departments, and physician practices., • Proficiency in reviewing and interpreting various types of clinical documentation and resolving complex coding challenges., • Strong understanding of official coding guidelines, coding conventions, and clinical documentation requirements., • Excellent written and verbal communication skills, with meticulous attention to detail and accuracy., • Access to current ICD-10-CM, ICD-10-PCS, and CPT code sets, along with the applicable Official Coding Guidelines.Preferred Qualifications, • Experience with medical record auditing, coding quality reviews, or clinical documentation improvement., • Familiarity with identifying documentation deficiencies and recommending appropriate provider queries., • Experience with AI training, data annotation, content validation, or model evaluation projects.

Job DescriptionJob Description: Certified Inpatient Coder Role Type: Contractor Location: United States (Remote) Job Summary We are seeking experienced Certified Inpatient Coders to support a project focused on improving medical coding accuracy, clinical documentation quality, and healthcare data integrity. In this role, you will apply your expertise in inpatient coding to review medical records, validate diagnosis and procedure codes, assess AI-generated clinical documentation, and ensure compliance with official coding guidelines. Your feedback will help improve the accuracy and reliability of AI systems used in healthcare. Scope of Work • Review and analyze inpatient medical records to ensure accurate ICD-10-CM and ICD-10-PCS coding in accordance with current official guidelines and industry best practices., • Evaluate clinical documentation for accuracy, completeness, consistency, and coding integrity., • Identify principal and secondary diagnoses, sequence codes according to the Official Guidelines for Coding and Reporting, and assign Present on Admission (POA) indicators., • Validate Medicare Severity Diagnosis-Related Group (MS-DRG) assignments, including the identification of Complications or Comorbidities (CCs) and Major Complications or Comorbidities (MCCs), and flag Hospital-Acquired Conditions (HACs) and relevant patient safety indicators., • Evaluate AI-generated clinical notes and summaries against source medical records and established coding standards., • Validate and assign appropriate diagnostic and procedural codes using ICD-10-CM and ICD-10-PCS classification systems., • Identify and resolve discrepancies in diagnosis and procedure coding to maintain accurate record abstraction and data integrity., • Provide clear, detailed written feedback on coding errors, documentation gaps, and complex cases to support continuous improvement in AI model performance.Preferred Qualifications, • Active certification in one or more of the following: Certified Inpatient Coder (CIC), Certified Coding Specialist (CCS), Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Outpatient Coder (COC), or another recognized AHIMA or AAPC coding certification., • Hands-on experience with inpatient ICD-10-CM and ICD-10-PCS coding., • Access to up-to-date official ICD-10-CM/PCS coding references and authoritative Coding Clinic guidance., • Current experience in inpatient medical coding, clinical documentation improvement (CDI), or a closely related healthcare documentation role., • Availability to contribute at least 10 hours per week., • Strong knowledge of inpatient coding guidelines, diagnosis sequencing, POA indicators, and MS-DRG assignment., • Excellent analytical skills, attention to detail, and the ability to identify and explain coding discrepancies., • Ability to work independently, follow established guidelines, and maintain high standards of accuracy and quality.Ideal Candidate Profile The ideal candidate is a certified inpatient coding professional with practical experience in ICD-10-CM/PCS coding, diagnosis sequencing, POA reporting, and MS-DRG validation. They can critically evaluate medical documentation, identify coding inconsistencies, and provide actionable feedback to improve the accuracy and reliability of AI-generated healthcare data.

Job DescriptionJob Description: Inpatient Coder (CCS) Role Type: Contractor Location: United States (Remote) Job Summary We are seeking experienced Inpatient Coders to support a project focused on improving clinical coding accuracy, medical documentation quality, and healthcare data integrity. In this role, you will apply your medical coding expertise to review inpatient medical records, validate clinical documentation, assess AI-generated clinical content, and ensure coding accuracy in accordance with established industry standards. Your knowledge will help improve the reliability and quality of AI systems used in healthcare. Scope of Work • Review and analyze inpatient medical records to ensure accurate ICD-10 and applicable CPT/HCPCS coding in accordance with current guidelines and industry best practices., • Evaluate clinical documentation for accuracy, completeness, consistency, and coding integrity., • Review AI-generated clinical notes and summaries against source medical records and established documentation and coding standards., • Validate and assign appropriate diagnostic and procedural codes using applicable ICD-10-CM, ICD-10-PCS, and CPT/HCPCS classification systems., • Identify and resolve discrepancies in diagnosis and procedure coding to maintain accurate record abstraction and data capture., • Enter and validate AI-generated patient information in computerized inpatient and outpatient medical record databases, following established workflows and quality standards.Preferred Qualifications, • Active certification in one or more of the following: Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC), Certified Outpatient Coder (COC), Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or another recognized AHIMA or AAPC coding certification., • Hands-on experience with ICD-10 coding and medical record review., • Access to current official ICD-10 and CPT coding references, along with Evaluation and Management (E/M) coding guidelines., • Current employment or recent experience in medical coding, clinical documentation improvement (CDI), or a closely related healthcare documentation role., • Availability to contribute at least 10 hours per week., • Strong attention to detail and the ability to identify coding discrepancies and documentation gaps., • Ability to work independently, follow established coding guidelines, and maintain high standards of accuracy and quality.Ideal Candidate Profile The ideal candidate is a certified medical coding professional with practical experience reviewing inpatient medical records, applying coding guidelines, and validating clinical documentation. They demonstrate strong analytical skills, coding accuracy, and the ability to evaluate AI-generated healthcare content against real-world medical records and established coding standards.

Job Description Hi, we're Oscar. We're hiring a Senior Manager, Revenue Cycle Management to join our Provider Operations 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 Senior Revenue Cycle Manager, Provider Operations is responsible for leading and optimizing revenue cycle operations across Oscar Medical Group. The role owns the development and execution of scalable revenue cycle strategies and processes that support accurate coding, compliant billing, timely reimbursement, and overall financial performance. This leader will serve as a subject matter expert in professional billing and coding and will partner closely with clinical, operations, finance, compliance, credentialing, product, to identify revenue cycle risks and opportunities and translate them into actionable operational strategies. The Senior Manager will establish performance standards, controls, reporting, and workflows across the revenue cycle while using data and root-cause analysis to drive measurable improvements in revenue capture, claims performance, coding accuracy, and provider documentation. This role will also provide strategic guidance to OMG leadership on revenue cycle performance, risks, and opportunities as the organization grows and evolves. You will report into the Director, Clinical Operations. Work Location: This position is based in our New York City, NY office, requiring a hybrid work schedule with 3 days of in-office work per week. Thursdays are a required in-office day for team meetings and events, while your other two office days are flexible to suit your schedule. #LI-Hybrid Pay Transparency: The base pay for this role is: $135,792.00 - $178,227.00 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: • Own the strategy and performance of OMG's revenue cycle function, including professional billing, coding, claims management, denials, eligibility, documentation, and related workflows., • Serve as the senior subject matter expert for coding and billing, including CPT, ICD-10-CM, HCPCS, modifiers, CCI/NCCI edits, and payer requirements., • Establish and monitor revenue cycle KPIs and controls, using data and root-cause analysis to improve clean claims, coding accuracy, reimbursement, denial rates, and overall financial performance., • Lead coding and documentation integrity strategies, including pre- and post-bill review, provider queries, addendums, signatures/co-signatures, identification of inappropriate documentation practices or cloning, and proactive provider education to address documentation gaps and support accurate coding., • Lead denial prevention and resolution strategies, identifying systemic trends and partnering across teams to implement sustainable corrective actions., • Partner with clinical leadership on ICD-10/HCC documentation and coding, identifying opportunities to improve accurate capture of clinically supported diagnoses., • Evaluate payer-specific performance, requirements, and coding considerations, developing strategies to address reimbursement, eligibility, claim edits, denials, and other revenue cycle issues while incorporating payer expertise into coding and operational processes., • Partner cross-functionally with Clinical Operations, Finance, Compliance, Credentialing, Product/Technology, and other stakeholders to resolve complex revenue cycle issues and support new programs and services., • Develop scalable revenue cycle policies, workflows, governance, and vendor oversight to support a growing, multi-state provider organization., • Advise OMG leadership on revenue cycle performance, financial opportunities, operational risks, and recommended strategies, leading complex initiatives from identification through implementation and measurement., • Compliance with all applicable laws and regulations, • Other duties as assigned Requirements: • 7+ years of progressive experience in healthcare revenue cycle, professional billing, coding, or related healthcare operations., • 3+ years of experience leading revenue cycle programs, teams, or functions with accountability for operational and/or financial outcomes., • Advanced knowledge of professional billing and coding, including CPT, ICD-10-CM, HCPCS, modifiers, CCI/NCCI edits, claims management, denial management, and payer requirements., • Experience developing and executing revenue cycle strategies that improve coding accuracy, claims performance, reimbursement, and overall financial outcomes., • Experience with coding and clinical documentation integrity, including provider documentation review, provider queries, and pre- and post-bill review processes., • Demonstrated ability to analyze complex revenue cycle data, identify trends and root causes, and translate findings into actionable strategies and recommendations., • Demonstrated experience leading complex, cross-functional initiatives, partnering with clinical, operations, finance, compliance, credentialing, and other stakeholders to drive results., • Strong executive communication skills, with the ability to clearly communicate complex revenue cycle performance, risks, opportunities, and recommendations to senior leadership. Bonus points: • Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Coding Specialist – Physician-based (CCS-P), Certified Professional Medical Auditor (CPMA), or comparable coding/revenue cycle certification., • Experience leading or overseeing coding professionals and/or certified coders., • Experience working within a multi-state medical group, telehealth organization, or other complex healthcare delivery environment., • Experience working within both provider and payer environments, providing an understanding of revenue cycle from both perspectives., • Experience with risk-adjustment coding, including ICD-10/HCC documentation and coding practices., • Experience with credentialing and payer enrollment processes and their downstream impact on revenue cycle performance., • Experience managing external revenue cycle, coding, or billing vendors. This is an authentic Oscar Health job opportunity. 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 (accommodations@hioscar.com) 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 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, • Group Auto and Homeowners Insurance Discounts Join our dynamic team where we value accuracy, efficiency, and continuous learning. We offer opportunities for professional growth, a collaborative work environment, and learning experience to support your career development. Requirements: Skills and Qualifications: • 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.

Job DescriptionJob Title: Billing & Credentialing Manager (hybrid), MDLand/iClinic EMR experience A BIG PLUS Location: Hybrid - 3 days a week across offices in Manhattan, New York City with option for 2 work from home days. Salary: $100,000 - $120,000 (Dependent on Experience). Hours: 40 hours/week. About Us: Join our dynamic outpatient medical practice specializing in primary care, endocrinology, psychotherapy, and dermatology. Located in the heart of New York City, we are committed to providing exceptional care to our diverse patient population. Our dedicated team thrives on professionalism, innovation, and a patient-centric approach. Position Overview: We are seeking an experienced Billing Manager to oversee our billing and collections process for 2,000-4,000 claims per month. This role is integral to maintaining the financial health of our practice while ensuring compliance with policies and regulations. The ideal candidate will have at least 5 years of experience in medical billing & credentialing, including supervising a billing team, and will ideally possess expertise in MDLand EMR. If you are detail-oriented, organized, and ready to make an impact, we want to hear from you! Key Responsibilities: • Manage the billing and collections processes for all services rendered, ensuring accuracy and timeliness., • Ownership of provider credentialing with all our contracted payors for new applications and maintenance of existing ones, including Medicare and NYS Medicaid, • Supervise and mentor the billing team, fostering a collaborative environment and promoting best practices in the billing workflow., • Oversee the submission of insurance claims and follow up on outstanding claims., • Analyze billing data and generate reports to identify trends and discrepancies., • Work closely with healthcare providers and office managers and staff in daily operations to resolve billing issues and ensure optimal revenue cycle management and clinical workflows, • Maintain compliance with billing regulations and guidelines., • Provide training and support to staff on billing procedures and software usage., • Develop and implement strategies to enhance billing efficiency and collections. Qualifications: • Certified Professional Coder (CPC) certification required., • Proven experience (minimum of 5 years) in medical billing and collections, including supervising a billing team., • Billing experience with primary care practice in NYC is a big plus, • Strong understanding of medical coding, billing regulations, and reimbursement processes., • Experience with MDLand is a big plus, • Excellent analytical and problem-solving skills., • Exceptional communication and interpersonal skills., • Ability to work independently in a remote environment while managing multiple tasks effectively. What We Offer: • Competitive salary and benefits package., • A supportive remote work environment with flexible scheduling., • Opportunity to be part of a dedicated team focused on patient care and satisfaction., • Professional development and growth opportunities within the organization. How to Apply: If you are interested in this exciting opportunity, please submit your resume along with a cover letter outlining your relevant experience. We look forward to welcoming a new member to our team who shares our commitment to quality healthcare!

Active coding certification such as Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Interventional Radiology Cardiovascular Coder (CIRCC), or equivalent. As an Interventional Radiology Coder, your specialized expertise will help support accurate coding, regulatory co

The Certified Professional Coder (CPC) is responsible for performing reviews, audits and coding oversight of medical records to ensure the appropriate CPT codes, diagnosis codes and modifiers according to Generally Accepted Medical Coding Guidelines, CPT-4; HCPCS; ICD-10 Guidelines; and, CMS Correct

NYC Health + Hospitals is the largest public health care system in the United States. We provide essential outpatient, inpatient and home-based services to more than one million New Yorkers every year across the city's five boroughs. Our large health system consists of ambulatory centers, acute care centers, post-acute care/long-term care, rehabilitation programs, Home Care, and Correctional Health Services. Our diverse workforce is uniquely focused on empowering New Yorkers. At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception. Every employee takes a person-centered approach that exemplifies the ICARE values (Integrity, Compassion, Accountability, Respect, and Excellence) through empathic communication and partnerships between all persons. Work Shifts: 9:00 A.M 5:00 P.M Purpose of Position: Under direction, provides centralized oversight of medical records and coding staff specializing in health information and clinical documentation management to ensure the maximum clinical documentation quality and coding. Analyzes and reviews provider documentation, claims and clinical data to ensure accuracy of all reported International Classification of Diseases (ICD) diagnoses and procedure codes to the highest-level descriptor to support the patient's acute/chronic conditions and treatment plans as well as reflect the appropriate severity of illness/risk of mortality of NYC Health + Hospitals' patient population. Performs quality reviews of health information documentation, contributes to the proper reporting of code assignment in order to facilitate consistent and efficient claims processing, data collection and quality metrics. Ensures patient centered quality of care; providing optimal utilization of resources, service delivery, and adheres to all relevant regulatory policies, procedures, and meet standards of care for better outcomes and improved patient experience. Essential Duties and Responsibilities: Performs pre-visit/retrospective current and/or longitudinal reviews for completeness. In addition, substantiate all ICD Procedural Coding System (PCS) diagnostic and therapeutic procedures or the AMA Current Procedural Terminology (CPT) Codes are reported affecting utilization and statistics. Captures and assesses physician documentation and queries for compliance in accordance with established guidelines, conventions and industry standards and meet the criteria for the ICD diagnoses codes used for Risk Adjustment Factors (RAF) scores to identify areas for educational opportunity for clinical and non-clinical staff, which will impact patient care and supportive services. Generates physician queries based on documentation and clinical indicators for suspected conditions that impact quality and/or reporting, so the physician may consider a definitive diagnoses and/or document clarification of specificity as requested into the health record. Provides feedback to facility staff on missed opportunities for documentation improvement. Ensures adherence to established policy and procedures. Engages in the evaluation of administrative systems employed in maintenance and utilization of health information records. Performs data quality assurance reviews for system functions and usage. Analyzes usage reports to identify trends in documentation inconsistencies, inadequacies and other issues to determine root cause, including but not limited to focused reviews i.e. Patient Safety Indicators (PSI) and Hospital Acquired Conditions (HAC) and identify process improvement opportunities in collaboration with the Quality professionals. Performs post-billing quality reviews and analysis of coding edits to identify resolution, automation, education or re-training to facilitate the processing of clean claims for billing. Participates in the denial review process to establish evidence of clinical or documentation to support the current billing which may include writing an appeal letter with said evidence to retain proper reimbursement. Ensures all denials are responded to in a timely manner for tracking and provides feedback to appropriate staff, as needed. Assists in the development, implementation and management of performance standards and strategic planning through preparation and/or presentation of financial statistics for Enterprise-level reporting for physician advisors, clinical leadership and key stake holders. Responsible for maintaining knowledge of regulations and updates in the reporting of ICD codes, disease pathophysiology and documentation requirements. Provides updates to staff, as necessary. Participates in the development and/or facilitating of training programs that provide systemwide education on documentation requirements in various healthcare settings, reimbursement and regulatory changes. Participates in facility new associate orientation, instructs and mentors appropriate staff, as needed. Acts as a subject matter expert resource and liaison with internal and external professional groups. Acts as a departmental representative on various committees or work groups. Assists in interdisciplinary efforts to review existing documentation and coding policies and procedures and makes necessary recommendations for improvement. May participate in performance measures and research activities. Performs related duties, as assigned. 1. Three (3) years of clinical experience as a Registered Professional Nurse (RN) and an additional two (2) years of Clinical Documentation experience; and valid certification from a nationally accredited organization in Coding or Clinical Documentation; or 2. One (1) year of clinical experience as a Nurse Practitioner (NP) or Physician Assistant (PA) and an additional two (2) years of Clinical Documentation experience; and valid certification from a nationally accredited organization in Coding or Clinical Documentation; or 3. Medical School Graduate; and two (2) years of medical record review, utilization review or case management experience; and valid certification from a nationally accredited organization in Coding or Clinical Documentation; or 4. Valid Registered Health Information Administrator (RHIA) credential from the American Health Information Management Association (AHIMA) or a Registered Health Information Technician (RHIT) credential from AHIMA; and three (3) years of satisfactory experience in Diagnosis-Related Group (DRG) validation and coding; or 5. High school diploma or its educational equivalent; and valid coding certificate from a nationally accredited association (i.e., Certified Coding Specialist (CCS) from AHIMA or Certified Professional Coder (CPC)); and six (6) years of satisfactory experience in coding, abstracting medical records and DRG validation in a healthcare environment. NYC Health and Hospitals offers a competitive benefits package that includes: Comprehensive Health Benefits for employees hired to work 20+ hrs. per week Retirement Savings and Pension Plans Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts Loan Forgiveness Programs for eligible employees College tuition discounts and professional development opportunities College Savings Program Union Benefits for eligible titles Multiple employee discounts programs Commuter Benefits Programs

Certified Coding Specialist (CCS) by AHIMA, Certified Professional Coder (CPC) by the American Academy of Professional Coders (AAPC) or Certified Medical Billing Specialist (CMBS) by the Medical Association of Billers (MAB); and two (2) years of experience in coding and/or abstracting medical record

Certified Coding Specialist (CCS) by AHIMA, Certified Professional Coder (CPC) by the American Academy of Professional Coders (AAPC) or Certified Medical Billing Specialist (CMBS) by the Medical Association of Billers (MAB); or 4. May organize, file and retrieve medical records. Carter excels at pro

Medical CoderRole Type: ContractorLocation: RemoteScope of WorkAnnotate and review medical records, ensuring accurate assignment of ICD-10 and CPT codes based on documentation. Preferred QualificationsActive AAPC Certified Professional Coder (CPC) certification is required.

AAPC Coding certification - Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA) or Certified Coding Specialist (CCS)Bachelor's degree in Nursing, Medical Billing/Medical Coding, Healthcare or other related fieldsPreferred candidate will have experience in Medicaid, Medi

Position Summary: We have an exciting opportunity to join our team as a Revenue Integrity Analyst (FGP) - Manhattan, CBO North Billing. Reporting to the Assistant Director, Professional Billing, the Revenue Integrity Analyst is responsible for managing, coordinating, and implementing charge capture initiatives and processes to improve revenue management and revenue protection and ensures the overall integrity of the charge capture process. The incumbent will also assist with the identification of front-end operation improvements in the Faculty Practices. Job Responsibilities: • Conducts internal audits and reviews activities to improve the revenue cycle, claims production and coding integrity., • Assist with special projects on as-needed basis., • Provides onsite support and assistance for new practices; train the staff on workflows and EPIC Charge and Edit work queues., • Monitor the Ambulatory Open Encounters report to ensure that charges are submitted time., • Leads and participates in moderately complex projects related to revenue cycle initiatives., • Analyzes billing error and denial data to identify root causes. Executes on work plans to correct identified deficiencies., • Conducts special projects and special studies to facilitate revenue management as required for system conversions, new facilities/acquisitions, new departments, new service lines, changes in regulations, legal reviews, etc., • Identify front-end operation improvements and assist with the conduct re-retraining., • Provides guidance and education related to billing and charge capture of services to multiple staff levels; facilitates proper recording of transactions in compliance with state, federal, and other third-party payer guidelines., • Maintains collaborative relationships with internal and external teams to ensure integration and alignment of department priorities., • Reviews, monitors, and facilitates implementation of billing and coding changes affecting charge capture processes in accordance with payer requirements., • Performs charge reconciliation process to ensure that charges are captured., • Performs various financial analyses and provides recommendations based on activities. Review monthly FGP revenue cycle metrics for areas of improvement within practices., • Implements charge capture corrective measures and monitoring tools to ensure sustainability of changes; performs, reviews, and monitors statistics and key performance indicators to identify improvement opportunities., • Works directly with Faculty Practice Billing Coordinators on developing and maintaining solvency within each practices revenue cycle. Review, monitors and tracks charge and edit work queues of each billing coordinator and provide support if needed. Minimum Qualifications: Bachelors degree and 4-6 years of auditing, revenue cycle management experience in a health care environment or equivalent combination of education and experience. Strong interpersonal communication and presentation skills, effectively presenting information to management, faculty practice groups and individuals Excellent organizational and project management skills. Strong time management, attention to detail, and follow through. Well-developed research skills. Strong knowledge of revenue cycle process, revenue integrity and its impact throughout the revenue cycle. Knowledge of: Current Procedures Codes (CPT) and International Class of Diseases Codes (ICD9/10) utilized in medical billing; medical billing software; healthcare billing including Medicare, Medicaid, or other third party payers; terminology utilized in medical billing; English usage, grammar, and spelling; basic math. Ability to: plan, schedule, assign, coordinate, and evaluate the work of billing staff; provide training; read, interpret, and apply policies and procedures; draw conclusions, and make recommendations; exercise independent judgment; maintain effective working relationships with subordinates, superiors, and others; maintain confidentiality. Preferred Licenses: Certified Professional Coder Preferred Qualifications: CPC Certification. Qualified candidates must be able to effectively communicate with all levels of the organization. NYU Langone Health provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents. At NYU Langone Health, we are committed to supporting our workforce and their loved ones with a comprehensive benefits and wellness package. Our offerings provide a robust support system for any stage of life, whether it's developing your career, starting a family, or saving for retirement. The support employees receive goes beyond a standard benefit offering, where employees have access to financial security benefits, a generous time-off program and employee resources groups for peer support. Additionally, all employees have access to our holistic employee wellness program, which focuses on seven key areas of well-being: physical, mental, nutritional, sleep, social, financial, and preventive care. The benefits and wellness package is designed to allow you to focus on what truly matters. Join us and experience the extensive resources and services designed to enhance your overall quality of life for you and your family. NYU Langone Health is an equal opportunity employer and committed to inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration. We require applications to be completed online. NYU Langone Health provides a salary range to comply with the New York state Law on Salary Transparency in Job Advertisements. The salary range for the role is $70,481.60 - $94,605.00 Annually. Actual salaries depend on a variety of factors, including experience, specialty, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.

Clear, professional communication skills.

A premier, global law firm seeks a Senior Billing Coordinator to join its Finance and Accounting Department.The firm is an elite international law firm of approximately 1,300 lawyers with 16 offices across six countries.The Senior Billing Coordinator will serve as the primary point of contact for a

Strong communication and interpersonal skills, with the ability to work effectively with attorneys, clients, and internal stakeholders in a professional environment.

Position: Client Accounts Coordinator.Salary: $95K – $120K + Bonus + Paid OT.Prestigious New York Law Firm seeks a Billing Coordinator to join their Team!.Responsible for producing prebills and ad-hoc reports both on-demand and periodically (monthly, quarterly or on-completion).Oversee the process

The ideal candidate is proficient in Excel, has strong analytical abilities, and possesses the organizational discipline required to manage a high volume of monthly billing activity while maintaining accuracy and professionalism.

Our client, a national law firm is hiring a Legal E-Billing Specialist for an immediate contract opportunity.This fully remote role manages electronic invoice submissions, resolves billing issues, and maintains accurate e-billing records across a high-volume operation.The position supports fiscal ye

McCarter & English, LLP is seeking a Billing & Collections Specialist for our Newark, NJ office.The salary range for this position is $80,000 – $90,000 annually, depending on experience.Candidates who receive an offer of employment will be processed through a background check which will be an indi

We are working with an international moving and relocation company that, due to the demand for their services, is looking to hire a knowledgeable and skilled Billing & Collections Specialist familiar with the moving industry.You will be responsible for managing the entire invoicing and collection pr

Depending on Experience, with Overtime and additional BONUS.With an international presence, they focus on several key industries, including private equity; asset management; life sciences and health care; investment banking; technology, media, and telecommunications; and consumer and retail.Their cl

Our client, a national law firm is hiring a Legal E-Billing Specialist for an immediate contract opportunity.This role manages electronic invoice submissions, resolves billing issues, and maintains accurate e-billing records across a high-volume operation.The position supports fiscal year-end billin

This is an outstanding opportunity for a billing professional seeking to advance their career within a prestigious, high-growth legal environment. Minimum of 4+ years of billing experience, ideally within a law firm or professional services environment.

Please connect with me on LinkedIn as well.K to $100K plus a performance-based bonus.Our client, an international AmLaw 100 firm, is looking to hire an E-Billing Specialist at their offices in New York City.The position will allow for a hybrid work schedule with 2 days a week onsite, WFH 3 days and

The ideal candidate has experience interacting with high level executives and can manage up through attention to detail, strong initiative, able to work independently, and a high level of confidentiality.This role will communicate, schedule, and collaborate with the Legal team, other teams within th

Law firm is hiring! The Billing Specialist will hamdle:.Create, verify, and deliver accurate invoices (electronically or by mail) based on contracts, purchase orders, or service logs.Monitor incoming payments, track overdue balances, and follow up with clients on outstanding accounts.Answer client b

Maintains professionalism and strict confidentiality in all client and Firm matters. Bachelor’s degree is required and 3 or more years progressive billing/e-billing experience preferably in a large legal or professional services firm is required; or equivalent combination of education and experien

Prior professional medical coding and billing experience required.

Responsible for accurately and efficiently processing insurance claims, primarily Medicaid, Medicare and Medicare and Medicaid HMO's.Monitor the progress of insurance claims from submission to payment.Identify and resolve claim denials, rejections, and delays.Follow up with insurance carriers to exp

Certified Professional Coder/AAPC. We are dedicated to building a supportive and welcoming environment where everyone has the opportunity to thrive and advance professionally.

Certified Professional Coder/AAPC. We are dedicated to building a supportive and welcoming environment where everyone has the opportunity to thrive and advance professionally.

Identifying and addressing overdue invoices promptly and professionally.

Certified Professional Coder/AAPC. We are dedicated to building a supportive and welcoming environment where everyone has the opportunity to thrive and advance professionally.

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

This position operates in a professional office environment and requires the ability to perform essential job functions with or without reasonable accommodation.

We are hiring detail-oriented professionals to manage end-to-end revenue cycle management (RCM) for our growing network of dental and medical practices across the United States. Respond to patient billing inquiries with clarity and professionalism. Professional development resources.

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

This role sits on the professional accounting track and requires experience in insurance or billing. Respond promptly and professionally to billing inquiries from policyholders and agents.