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Job DescriptionJob Title: Medical Coder Job Type: Contractor Location: Remote Job Overview We are seeking experienced Medical Coders to contribute their healthcare coding expertise to an innovative project focused on improving next-generation AI systems. In this role, you will review and annotate medical records, evaluate coding accuracy, and provide expert feedback to support the development of high-quality medical datasets. No prior AI experience is required—your coding expertise and attention to detail are what matter most. Key Responsibilities Review and annotate medical records to accurately assign ICD-10 and CPT codes based on clinical documentation. Apply Evaluation & Management (E&M) guidelines to assess coding levels and validate healthcare datasets. Ensure compliance with current medical coding standards and guidelines. Analyze clinical documentation and identify coding-related ambiguities or inconsistencies. Provide expert feedback on coding guidelines, edge cases, and documentation scenarios. Collaborate with project teams through written and verbal communication to improve AI training data quality. Required Skills Medical Coding ICD-10 CPT CPC Certification Evaluation & Management (E&M) Clinical Documentation Review Coding Accuracy & Compliance Attention to Detail Written & Verbal Communication Preferred Qualifications Active AAPC Certified Professional Coder (CPC) certification required. Strong knowledge of ICD-10, CPT coding systems, and E&M leveling guidelines. Experience working with diverse clinical documentation types. Ability to interpret complex medical records and apply appropriate coding standards. Strong written and verbal communication skills. Familiarity with digital annotation tools or healthcare data projects is a plus. Commitment to accuracy, quality, and continuous learning in healthcare coding and technology

Job Description POSITION SUMMARY This position will be responsible for performing on-going auditing of outpatient provider coding, and education. Individuals must be a certified coder, with experience in NY Medicaid regulations. The Senior Coding & Billing Specialist is responsible for auditing outpatient provider coding and documentation to ensure accurate code assignment, regulatory compliance, and optimal reimbursement. This position serves as a subject matter expert in CPT, ICD-10-CM, HCPCS, New York State Medicaid, CMS, and commercial payer requirements, ensuring services are coded and billed accurately in accordance with applicable federal, state, and payer guidelines. In addition to coding audits, this role is responsible for reviewing and resolving billing work queues, analyzing claim denials and reimbursement trends, identifying charge capture and documentation opportunities, and supporting timely claim resolution. The Senior Coding & Billing Specialist partners with providers, operations, finance, and revenue cycle leadership to improve documentation quality, reduce denials, optimize reimbursement, and strengthen overall revenue integrity through education, Epic optimization, auditing, and continuous process improvement. DUTIES AND RESPONSIBILITIES Revenue Cycle Coding Functions (45%) • Identify provider documentation improvement opportunities through coding audits and collaborate with providers and clinical leadership to enhance documentation quality and optimize reimbursement., • Identify coding, billing, charge capture, and documentation issues impacting reimbursement and provide recommendations for corrective actions to the VP of Revenue Cycle., • Identify coding-related payer denials and collaborate with appropriate stakeholders to reduce denials and improve coding accuracy., • Maintain current knowledge of CPT, ICD-10-CM, HCPCS, CMS, New York State Medicaid, and commercial payer coding requirements and educate providers and staff in regulatory updates., • Analyze trends in provider documentation, coding accuracy, and missed coding opportunities, and develop professional educational materials and recommendations for providers., • Collaborate with third-party revenue cycle vendors to identify coding issues and opportunities and develop remediation plans., • Recommend Epic automation, SmartSets, documentation templates, hard stops, soft stops, and workflow enhancements to improve coding accuracy, documentation compliance, and reimbursement., • Perform other duties and special projects as assigned. Revenue Cycle Billing (40%) • Work assigned Epic billing work queues (WQs) to timely resolution, ensuring accurate claim submission and reimbursement., • Identify Epic billing work queue issues and collaborate with Revenue Cycle leadership to develop and implement corrective action plans and workflow improvements., • Identify billing edits, charge capture, pricing discrepancies, claim rejections, and reimbursement issues, and recommend corrective actions to optimize revenue., • Perform billing and reimbursement audits utilizing EpicSlicerDicer and various other reporting tools, and advanced Microsoft Excel functions, including Pivot Tables to ensure compliant billing and accurate reimbursement., • Maintain current knowledge of New York State Medicaid, CMS, and commercial payer billing regulations, reimbursement methodologies, and payer contract requirements, and communicate updates to appropriate stakeholders., • Monitor billing work queues, denial trends, and timely filing requirements to improve first-pass claim acceptance and reduce revenue leakage., • Collaborate with the VP of Revenue Cycle Operations and Optimization to resolve complex billing and reimbursement issues., • Identify opportunities for Epic billing automation, workflow optimization, and process improvement to enhance operational efficiency and reimbursement., • Participate in revenue cycle initiatives, system testing, and special projects as assigned. Training and Education (15%) • Develop and provide ongoing education for current and new providers regarding coding accuracy, documentation requirements, reimbursement, and regulatory compliance., • Evaluate the results of internal and external coding audits and partner with Revenue Cycle, Operations, and Clinical Leadership to provide education, feedback, and corrective action plans to improve provider coding performance and documentation quality., • Maintain current knowledge of CMS, New York State Medicaid, and commercial payer coding and billing regulations, and communicate updates to providers and Revenue Cycle staff., • Complete all required organizational training and participate in departmental meetings, educational sessions, and revenue cycle initiatives. CORE COMPETENCIES • A demonstrated commitment to PPGNY’s mission related to bodily autonomy, health equity, gender and racial justice., • A demonstrated commitment to learning about and enhancing practices related to racial equity and its impact on healthcare systems., • Strong relationship building skills, including an ability to work and build trust across cultural differences related to race, age, gender, gender identity and expression, sexual orientation, religion, ethnicity, national origin or ability; and to reflect on one’s personal identity with humility., • Customer service and interpersonal skills and the ability to coordinate work with others, both internally and externally, engages in mutual problem solving. REQUIRED SKILLS/ABILITIES • Knowledge of Third-party payer contracts and Medicaid reimbursement, • CPT4 ICD-10 coding requirements and compliance and all other carrier guidelines; strong knowledge of New York State Medicaid rules., • Ability to learn data and analytics techniques to ensure good decision making, performance measurement and financial analysis., • Strong time management skills, including the ability to work in a high distraction environment and to juggle multiple deliverables at one time., • Excellent interpersonal, written and verbal skills and the ability to explain complex coding regulations to individuals who are not subject matter experts., • Strong team building skills., • Proficient with Microsoft Office Suite, including Excel skills, such as macros, pivot table and v look up options., • Demonstrated ability to learn new systems., • Process improvement orientation., • Proven ability to remain focused and calm in stressful situations. REQUIRED QUALIFICATIONS Minimum Education and Work Experience • High school diploma/GED., • Five plus years’ experience in outpatient provider coding, including coder certification., • Five plus years’ experience in compliant provider documentation., • Three plus years’ experience in EPIC EMR coding, billing and provider documentation., • Strong knowledge and utilization of Microsoft Windows, Excel, Word, Power Point and Outlook., • Strong CMS Compliance knowledge and audit guidelines. PREFERED QUALIFICATIONS • Associate’s degree in business. TYPICAL PHYSICAL DEMANDS Requires prolonged sitting and repetitive tasks including use of a computer. Periodic standing, walking, bending. Requires lifting or moving of up to 15 pounds. Visual acuity sufficient to perform frequent work on a computer screen and review printed reports and other materials. Requires the ability to hear and to communicate orally with others. This role routinely uses standard office equipment such as computers, phones, photocopiers, and filing cabinets, and will require reaching, grasping, pushing, and pulling. TYPICAL WORKING CONDITIONS This job operates in a professional office environment. Potential exposure tocommunicable diseases and other conditions in a health center environment. Requiresflexible schedule and during peak activity periods work more than 7.5 hours per dayand/or 37.5 hours per week. PPGNY's benefits package includes:Generous PTO and holiday scheduleMedical, dental and vision coverage options for you and eligible dependentsFSA, HSA, Commuter pre-tax reimbursement fundsShort- and Long-Term Disability, Free Basic Life and AD&D401(k) Retirement Plan with Safe Harbor contributions after 1 year of employmentAll positions at PPGNY require:Proof of immunization or immunity to certain communicable diseases (including influenza during the flu season and Covid-19) and testing for tuberculosis. These certifications are required by the NYC DOHMH Health Code, NYSDOH and OSHA. Planned Parenthood of Greater New York (PPGNY) is a leading provider, educator, and advocate of sexual and reproductive health care in New York State. PPGNY is proud to provide a wide-range of family planning services at our brick-and-mortar health centers and mobile care units. We care for everyone regardless of their immigration status, zip code or ability to pay. PPGNY’s education and outreach programs are backed by medically accurate, evidence-based information that allows people to make informed decisions about their health and future. As a voice for reproductive freedom, PPGNY supports legislation and policies that ensure all New Yorkers have access to the full range of reproductive health care and education. At PPGNY, we provide the absolute best care to our patients and our communities through innovative health care delivery and education programming. We care for everyone who walks through our doors regardless of insurance, ability to pay or immigration status. As a leading voice for reproductive freedom, PPGNY fiercely advocates for policies to ensure that all New Yorkers will have access to the full range of reproductive health care services and information. PPGNY is committed to diversity, equity, and inclusion. We believe we are most impactful when people with a wide range of backgrounds, experiences, and identities come together with common purpose. We encourage candidates from all backgrounds to apply.

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. \n \n The Advisory Group is currently accepting applications for a Certified Coding Auditor to work in its New York office or remotely. \n \n Principal duties and responsibilities: \n \n Perform remote billing and coding audits to ensure client coding practices are compliant with regulations and coverage policies for both government and commercial payers. \n \n 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. \n \n Qualifications: \n \n 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 inpatient and outpatient settings. \n \n 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. The focus will be in the primary care sector (fee-for-service and risk-based), though experience in specialties such as dermatology, vascular, podiatry, wound care, home health, and personal care is preferred. Behavioral health experience is also a plus. \n \n 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. \n \n 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. \n \n Familiarity with both UB-04 and CMS 1500 claims data, as well as understanding of payor remittances. \n \n Knowledge of anatomy, physiology, and medical terminology necessary to appropriately review assignment and documentation of diagnosis codes. \n \n Solid working knowledge of various EHR/EMR systems; experience accessing these remotely. \n Strong organizational skills and task management \n \n Highly organized with a high level of attention to detail \n \n Ability to work in a fast paced and rapidly changing environment. \n \n Skilled at multi-tasking with the ability to handle several different priorities simultaneously. \n \n Strong communication skills with experience in articulating audit findings and interpretation of coding regulations \n \n Experience with HIPAA, data privacy, and/or data security processes. \n Experience working with regulators governing (public or private) health insurance carriers. \n \n A minimum of AAPC or AHIMA certification required, that could include: \n \n · Certified Professional Coder (CPC) \n · Certified Outpatient Coder (COC™) \n · Certified Professional Medical Auditor (CPMA) \n · Certified Risk Adjustment Coder (CRC™) \n · Certified Coding Specialist (CCS) \n · Certified Coding Specialist – Physician based (CCS-P) \n \n For consideration, please email resume and cover letter as attachments with salary expectations to careers22@marwoodgroup.com with the subject title “Certified Coding Auditor - Primary Care.” \n \n 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. 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. \n \n The position is based in our New York location. Currently working a hybrid schedule. Remote option will be considered. \n \n 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. \n

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.

Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) or Certified Coding Specialist-Physician (CCSP), Certified Inpatient Coder (CIC), or Certified Outpatient Coder (COC), required. For outpatient encounters, applies coding conventions and official coding guidelines approved by th

Requirements Requires current Registered Health Information Technologies (RHIT) or Certified Professional Coder designation from the American Academy of Professional Coders or a Certified Coding Specialist, P from the American Health Information Management (AHIMA).

Requirements Must hold and maintain current Certified Professional Coder (CPC) credential. Certified Medical Coder, Springville NY Per Diem. Bertrand Chaffee Hospital is searching for a Per Diem Certified Professional Coder to join our team.

Requirements Requires current Registered Health Information Technologies (RHIT) or Certified Professional Coder designation from the American Academy of Professional Coders or a Certified Coding Specialist, P from the American Health Information Management (AHIMA). Knowledge of medical terminology

At MedReview, our mission is to bring accuracy, accountability, and clinical excellence to healthcare. We are a leading authority in payment integrity solutions including DRG Validation, Cost Outlier and Readmission reviews. We are seeking a registered nurse with experience in clinical validation to work within our coding department. Candidate should be highly motivated, with strong clinical and coding background. This individual must have excellent communication skills and an analytical mindset to achieve and maintain high-level performance in a fast-paced environment. This is a fulltime position (40 hours per week) Monday – Friday. You'll enjoy the flexibility to telecommute from anywhere within the United States. Training will be conducted virtually from your home. Responsibilities: • Perform clinical validation by ensuring diagnosis codes billed by the provider are supported within the medical record, • Must be able to interpret clinical guidelines/criteria and apply to clinical review, • Solid understanding of anatomy and physiology, diagnostic and surgical procedures developed from specialized training and extensive experience with ICD-10-PCS code assignments, • Demonstrates the ability to accurately interpret the medical record, • Writes clear, accurate and concise rationales in support of findings, • Maintains and manages case reviews with a high emphasis on quality, • Demonstrates the ability to work in a high – volume production environment, • Knowledge of health insurance business, industry terminology, and regulatory guidelines Qualifications: • Minimum of two years' experience in clinical validation in a payment integrity setting required, • May consider nurses with inpatient claims auditing experience or case management experience., • Unrestricted Registered Nurse with active RN licensure required, • CCS (Certified Coding Specialist) or CIC (Certified Inpatient Coder) certification preferred, • CCDS or CDIP Certification preferred, • Knowledge of ICD-10 coding, • Basic Knowledge of DRG validation and coding, • Ability to use Windows PC with the ability to utilize multiple applications at the same time Remote Work Requirements: • High speed internet (100 Mbps per person recommended) with secured WIFI., • A dedicated workspace with minimal interruptions to protect PHI and HIPAA information., • Must be able to sit and use a computer keyboard for extended periods of time. Benefits and perks include: • Healthcare that fits your needs - We offer excellent medical, dental, and vision plan options that provide coverage to employees and dependents., • 401(k) with Employer Match - Join the team and we will invest in your future, • Generous Paid Time Off - Accrued PTO starting day one, plus additional days off when you're not feeling well, to observe holidays., • Wellness - We care about your well-being. From Commuter Benefits to FSAs, we've got you covered., • Learning & Development - Through continued education/mentorship on the job and our investment in LinkedIn Learning, we're focused on your growth as a working professional. Salary Rate: $85,000 – 95,000/Annually.

Performs timely and accurate coding of the visit; ensuring diagnosis to the highest specificity, accurate E/M level and capture of all procedures/modifiers.Reviews the medical record to ensure consistency and accuracy as well as compliance with established third-party reimbursement agencies.Particip

LICENSURE OR CERTIFICATION: Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA), or Certified Coding Specialist (CCS), or Certified Coding Specialist-Physician-based (CCS-P), or Certified Professional Coder (CPC), or Certified Inpatient Coder (CIC)

Requirements Requires current Registered Health Information Technologies (RHIT) or Certified Professional Coder designation from the American Academy of Professional Coders or a Certified Coding Specialist, P from the American Health Information Management (AHIMA).

A remote healthcare solutions provider is seeking a Certified Professional Coder (CPC) to manage denial issues and ensure accurate medical billing. This full-time position is fully remote, with compensation of up to $10/hr.

A healthcare organization in Bronx, NY is looking for a denial management specialist to research and analyze denials and optimize revenue collection. Ideal candidates will have 3-5 years of experience in healthcare appeals, strong analytical skills, and knowledge of coding standards. A Bachelor's Degree is preferred alongside a Certified Professional Coder (CPC) certification. This position offers a competitive salary range of $49,920.00-$62,400.00. #J-18808-Ljbffr

Legal/Compliance New York, NY NYU Langone Health is a fully integrated health system that consistently achieves the best patient outcomes through a rigorous focus on quality that has resulted in some of the lowest mortality rates in the nation. NYU Langone offers a comprehensive range of medical services with one high standard of care across 6 inpatient locations, its Perlmutter Cancer Center, and over 320 outpatient locations in the New York area and Florida. With $14.2 billion in revenue this year, the system also includes two tuition-free medical schools, in Manhattan and on Long Island, and a vast research enterprise with over $1 billion in active awards from the National Institutes of Health. Position Summary: We have an exciting opportunity to join our team as a Senior Compliance Specialist. The Senior Compliance Specialist (Hospital Billing Auditor) will support the Manager of Hospital Billing Compliance and the Director of Billing Compliance in the development and implementation of the Hospital Billing Compliance program at NYU Langone Health System to ensure adherence with federal and state billing regulations. Primary responsibilities include conducting audits to determine organizational integrity of billing facility and technical hospital fees, including identifying areas requiring improvement, and providing recommendations and education to providers and staff. Job Responsibilities: • Assists with management of the comprehensive Hospital Billing Compliance workplan to ensure that billing and coding of hospital services are in accordance with federal, state, local and managed care payor regulations., • Conducts risk assessments to define audit priorities by evaluating previous audit findings, management priorities, ICD, APC and DRG utilization patterns, national normative data, CMS and PEPPER initiatives, OIG work plans and advisories, and healthcare industry best practices., • Conducts Hospital Compliance audits consisting of evaluation of adequacy and accuracy of documentation in support of services billed, including ICD/CPT/HCPCS and other third-party payor codes, DRG assignment, APC code assignment, medical necessity of services, and compliance with other documentation, coding and billing standards., • Adheres to audit timeline and audit protocol standards; assists with development of audit schedules., • Prepares written reports of audit findings and recommendations and presents the findings to leadership of the respective department, coding staff, Health Information Management staff and others as appropriate; evaluates the adequacy of management action plan, as needed, to improve deficiencies., • Evaluates the adequacy and effectiveness of internal and operational controls designed to ensure that processes and practices lead to appropriate execution of regulatory requirements and guidelines related to facility and technical fee documentation, coding and billing, including federal and state regulations and guidelines, CMS and other third-party payor billing rules, and OIG/OMIG compliance standards., • Develops a comprehensive education program to train department managers, staff and physicians in all areas of compliance and billing requirements. Provides information which is clear and coherent. Prepares presentations and develops training materials as needed., • Assists Compliance Department management with federal, state and other special investigations and audits., • Effectively maintains collaborative working relationships with department leadership and Revenue Cycle Operations management team to provide education on improvements in billing and documentation practices., • Serves as subject matter expert and authoritative resource on interpretation and application of documentation and coding rules and regulations and medical necessity of services delivered., • Annually identifies specific needs for self-development and implements a plan to achieve professional growth., • Maintains privacy of patient information and confidentiality of compliance information and activities., • Assists in any special projects and/or internal or external federal or state agency inquiries and performs and participates in other related duties as required. Minimum Qualifications: To qualify you must have a Bachelors degree in Finance, Healthcare administration or related field. Minimum of 4 years of hospital coding and billing experience. Certification in clinical coding is required. Strong problem solving and analytical skills. Excellent verbal and written communication skills. Proficiency in Microsoft office. Must be able to communicate with physicians, senior administrators and office staff. Epic systems and/or EHR experience. Preferred Qualifications: Bachelors degree in Nursing or Masters degree in Nursing. Hospital Billing experience in a large academic health care setting. 4-5 years of experience in facility fee auditing/coding or medical necessity reviews or related work. Ability to understand and interpret medical records, hospital bills, and the charge master as well as an understanding of all ancillary department functions. Holds one of the following coding certifications: MPG-Certified Inpatient Coder (CIC). AHIMA - Certified Coding Specialist (CCS), or AHIMA Certified Coding Associate (CCA). Proficiency in payment review systems, hospital information systems, and clinical record information systems. Knowledge of regulatory agencies requirements (CMS, NYS Medicaid, OIG and OMIG). Strong quantitative, analytical, communication and interpersonal skills and ability to work collaboratively with team members and others. 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. View Know Your Rights: Workplace discrimination is illegal. 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 $84,577.92 - $142,767.54 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. To view the Pay Transparency Notice, please click here

Health Information Management Performs coding and abstracting duties to assure accurate completion of coding for all assigned patient records. • Analyzes and interprets the medical record in its entirety to ensure accurate, complete and consistent selection of diagnoses and procedures to assure the production of quality healthcare data and accurate facility payment. Applies understanding of basic anatomy and physiology to interpret clinical documentation and identify applicable codes., • Utilizes resources and reference materials (e.g., manuals, online resources: Official Coding Guidelines (OCG), AHA Coding Clinic, Center for Medicare Services and CPT Assistant) to identify appropriate codes and reference code applicability, rules and guidelines., • Applies the Uniform Hospital Discharge Data Set (UHDDS) definitions as well as any additional regulatory guidelines and/ or coding references to select the principal diagnosis, secondary diagnoses, all significant procedures, indicating the patient's acuity, severity of illness and risk of mortality (if applicable), as documented in the medical record., • Codes and reports diagnoses and their associated present on Admission (POA) Indicator and procedures., • Accurately assigns discharge disposition for all records as required and in accordance with the Centers for Medicare and Medicaid Services (CMS) rules and regulations., • Make determinations on medical coding and takes initiative to complete reviews and coding independently, to avoid delays in the workflow process., • Manages multiple work demands simultaneously to maintain relevant efficiency and turnaround time standards for completing coding/DRG assignment., • Assigns and reports all other data elements required for Statewide Planning and Research Cooperative System (SPARCS) data collection, Congenital Malformations and Expirations., • For outpatient encounters, applies coding conventions and official coding guidelines approved by the Current Procedural Terminology (CPT) rules established by the American Medical Association (AMA), and any other official rules and guidelines established for use with the mandated outpatient procedure code sets., • Assigns appropriate discharge physician in the system., • Generates compliant physician queries to clarify any incomplete/ambiguous or conflicting documentation and applies post-query responses to make final coding determinations., • Demonstrates basic knowledge of the impact of coding decisions on revenue cycle., • Assists in the education of physicians and other clinicians by advocating proper documentation practices, further specificity, resequencing and inclusion of diagnoses or procedures when needed to more accurately reflect the acuity, severity of illness and risk of mortality as indicated., • Attends and participates in required hospital education programs in order to maintain and enhance their coding skills and stay abreast of changes in codes, coding guidelines and regulations., • Completes moderately complex assignments that require an ability to recognize the need to occasionally deviate from accepted practices., • Exercises independent judgment on basic or moderately complex issues regarding job and related tasks., • Works independently under minimal supervision within established guidelines and procedures., • Requires minimal instruction on day-to-day work; majority of work is self-directed; receives instruction on new assignments., • Works with lead on resolution of day-to-day technical/procedural challenges. May provide work guidance to team members to ensure accurate and timely completion of tasks., • Performs related duties, as required., • High School Diploma or equivalent required., • 3 - 5 years of technical experience, required., • One or more of the following required: Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) or Certified Coding Specialist-Physician (CCSP) or Certified Inpatient Coder (CIC) or Certified Outpatient Coder (COC) or RHIA or RHIT certification., • Inpatient facility coding experience, preferred. *ADA Essential Functions *Additional Salary Detail The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).

The Certified Professional Coder (CPC) serves as liaison between the medical group and the external coding vendor. This role ensures consistent communication, accurate and compliant coding practices, timely issue resolution, and alignment with organizational policies and payer requirements. The Coding Liaison supports documentation integrity, monitors vendor performance, and acts as a subject matter expert for coding-related inquiries. This role works closely with providers, clinical staff, and revenue cycle teams to review medical records, validate documentation completeness, apply correct CPT, ICD-10-CM, and HCPCS codes, and educate providers on documentation best practices. Key Responsibilities • Serve as the liaison to ensure coding queries issued by the vendor are addressed by providers, resolved appropriately, and returned to the vendor in accordance with established timelines., • Identify documentation deficiencies and initiate provider queries when clarification is needed, • Apply current CMS, payer, and organizational coding guidelines, • Assist with coding-related denials, audits, and appeals, • Stay current with coding updates, rule changes, and ongoing education requirements Medical Coder Qualifications/Skills: Active AAPC certification (CPC) 3+ years of medical coding experience. Strong knowledge of: CPT, ICD-10-CM, and HCPCS coding guidelines E/M coding (including 2021+ E/M guidelines if applicable) CMS and major payer regulations Provider education and relationship management Preferred Qualifications Proficiency in electronic health records (EHR) and encoder systems Experience in hospital, multispecialty, or high-volume outpatient environments Familiarity with auditing, compliance programs, and denial resolution Excellent attention to detail and analytical skills Strong written and verbal communication skills Administrative writing skills Reporting skills Proficiency in Microsoft Office Product Suite. St. Joseph's Health is recognized for the expertise and compassion of its highly skilled and responsive staff. The combined efforts of the organization's outstanding physicians, superb nurses, and dedicated clinical and professional staff have made us one of the most highly respected healthcare organizations in the state, the largest employer in Passaic County, and one of the nation's "100 Best Places to Work in Health Care". Benefits Eligibility: (Full-time and Part-time Employees-over 20 hours a week) • Competitive salary*, • Robust benefits with health, dental, Rx and vision plans, • 403b retirement plan options with company match**, • Health & Wellness*, • Non-Profit Health System eligible for Federal Student Loan Forgiveness, • PTO, and paid holidays, • Tuition reimbursement, • Employee Assistance Program, • LTD : Long Term Disability, • Life Insurance Options, • Onsite Day care Program *Available for Per Diem Employees and Part-time Employees working under 20 hours per week. 403b Company Match not applicable for Per Diem Employees and Part-time Employees working under 20 hours per week. Pay transparency: St. Joseph's Health provides a salary range to comply with New Jersey Law. The rate of pay for each position will be determined based on a variety of factors including the candidate's relevant experience, qualifications, skills, etc." The salary range does not include incentives, differential pay or other forms of compensation. St. Joseph's University Medical Center is an academic tertiary care medical center and state designated trauma center, located on the Paterson campus, regularly accepts referrals of difficult or unusual cases from other hospitals and physicians and performs both complex and routine procedures. The Medical Center offers a full complement of specialty and subspecialty services including ambulatory, behavioral health, cardiovascular, emergency/trauma, internal medicine, neuroscience, oncology, orthopedic/spine, rehabilitation, surgical specialty, women's health, imaging and pediatrics. The nursing team at St. Joseph's University Medical Center, which includes St. Joseph's Children's Hospital, has held the Magnet Award for Nursing Excellence, the profession's highest honor, since 1999. They are also recipients of the prestigious 2010 Magnet Prize - one of only 8 Magnet-designated hospitals to ever receive The Magnet Prize, and the only one worldwide to receive the 2010 award. • Job Identification 20251609, • Job Category Allied Health, • Posting Date 01/16/2026, 08:24 PM, • Job Schedule Full time, • Job Shift Day, • Locations St. Joseph's University Medical Center (On-site), • Hourly Salary Range 30.88 - 47.86

As a Specialist, Revenue Cycle , you will independently perform day-to-day revenue cycle activities for Morlen Health programs , including insurance eligibility and benefits verification, prior authorization management, coding support, charge entry, claims processing, and routine denial resolution. You will apply established revenue cycle practices and payer requirements to resolve routine issues, support accurate and timely reimbursement, and reduce administrative barriers to patient access. Working across Patient Services, clinical leadership, Finance, referring providers, and insurance payers, you will identify revenue cycle trends and workflow opportunities and recommend improvements. As Morlen Health expands into additional commercial payer relationships, programs, and markets, you will contribute to the development and implementation of scalable revenue cycle processes. This is a full-time, remote position . In This Role, You Will... Independently perform routine day-to-day revenue cycle activities in accordance with organizational procedures, payer requirements, and established controls. Conduct patient eligibility and benefits verification and determine required administrative next steps. Manage prior authorization and referral requirements from initiation through completion, including monitoring expiration dates, outstanding information, and renewal needs. Review documentation for billing readiness and coordinate resolution of routine documentation deficiencies before charge entry and claim submission. Complete accurate and timely charge entry in system based on documented services and established coding protocols. Prepare and submit claims and monitor them throughout the revenue cycle, researching and resolving routine claim edits, rejections, and denials. Communicate directly with insurance payers to investigate billing, authorization, reimbursement, and claim issues. Apply established coding protocols and documentation standards to pulmonary rehabilitation and related services, including assigning CPT codes based on clinical documentation and established practices. Coordinate with referring provider offices to obtain documentation required for authorization, billing, and patient onboarding. Assist patients and caregivers with routine questions regarding coverage, benefits, authorization requirements, and administrative status. Monitor revenue cycle performance measures, identify trends and recurring issues, and communicate significant findings to appropriate stakeholders. Recommend practical process and workflow improvements and support implementation of approved changes. Develop and maintain payer-specific workflows and operational reference materials. Collaborate with Patient Services, clinical leadership, Finance, referring providers, and payer representatives to support accurate information flow and continuity of revenue cycle activities. What You Need to Be Successful... 3+ years of experience in healthcare revenue cycle, medical billing, patient access, healthcare operations, or a related healthcare administrative function. Experience independently performing multiple components of the revenue cycle, such as eligibility and benefits verification, prior authorizations, charge entry, claim submission, claim follow-up, or denial resolution. Experience working with electronic medical record, practice management, or healthcare billing systems. Experience researching and resolving routine payer, billing, authorization, or reimbursement issues. Working knowledge of healthcare revenue cycle processes, medical terminology, medical billing practices, and CPT and ICD-10 coding concepts. Strong analytical and problem-solving skills with the ability to research revenue cycle issues and determine appropriate next steps. Strong attention to detail and the ability to independently manage competing priorities, follow-up activities, and deadlines. Sound judgment and the ability to recognize when clinical, contractual, compliance, policy, or leadership escalation is needed. Strong written and verbal communication skills and the ability to collaborate effectively with clinical, operational, financial, patient, provider, and payer stakeholders. Proficiency with Microsoft Office and web-based healthcare applications. Preferred: Associate’s or Bachelor’s degree in Healthcare Administration, Business Administration, Health Information Management, or a related field. American Academy of Professional Coders (AAPC) Certified Professional Coder (CPC) certification. Experience with Athenahealth. Experience with commercial insurance plans and Medicare. Experience with insurance verification and prior authorizations. Experience in pulmonary rehabilitation, cardiopulmonary medicine, rehabilitation, or an outpatient specialty practice. Your Compensation... The annual salary range for this position is $19.65-33.50 per hour. Actual compensation will be determined based on factors such as an applicant’s skills and qualifications, education and certifications, training, relevant experience, market data, geographic location, internal equity, and other job-related factors. In addition to base salary, Morlen Health offers a comprehensive benefits package that includes medical, dental, and vision coverage; retirement benefits; paid time off; paid holidays; and other benefits and programs. Specific details are below, and specific plan information is available upon request. Medical coverage with HMO and POS plan options; employee-only coverage is 100% employer paid for eligible full-time employees. Dental and vision coverage, including preventive dental care, orthodontia benefits, annual eye exams, eyewear and contact lens allowances, and vision discounts. Health Care and Dependent Care Flexible Spending Accounts (FSAs) for eligible expenses. Employer-provided short- and long-term disability coverage. 401(k) retirement savings plan with a broad range of investment options and retirement planning resources. Paid time off and company-paid holidays. Employee Assistance Program (EAP) with confidential emotional health, work-life, legal, financial, childcare, eldercare, and wellness resources for employees and household members. Voluntary supplemental benefits, including accident, critical illness, and hospital indemnity coverage. Dedicated benefits support through ADP TotalSource MyLife Advisors. About Morlen Health Morlen Health was created by the physicians of Northwest Permanente PC to create, protect, and grow innovative healthcare solutions for their patients and communities. We have a relentless focus on best‑in‑class quality patient care and outcomes. Morlen Health is dedicated to delivering affordable, high‑quality healthcare at individual and population levels. Through our population health services and digitally enabled solutions, we are working to improve access, engagement, health outcomes, and the overall care experience. #J-18808-Ljbffr

Job Details City/State: Bronx, New York Grant Funded: No Department: NoMgr Work Shift: Day Work Days: MON-FRI Scheduled Hours: 8:30 AM-5 PM Scheduled Daily Hours: 7.5 HOURS Pay Range: $49,920.00-$62,400.00 Responsibilities Researches and analyzes denials on a daily basis, identifies root causes, and processes resubmissions/appeals with the goal of overturning the denial and getting paid by the insurance carrier, maximizing revenue for the division. Qualifications Three to five years of progressive experience in appeal/denial management - Preferred Strong knowledge of health plan requirements Strong analytical, statistical analysis skills required Strong knowledge of EPIC, Microsoft Excel, Word and Power Point skills required Knowledge of federal, regional and state payer coverage patterns (CMS, fiscal intermediary, and Administrative) Strong organizational and communication skills; professionalism, able to work with all levels of staff. Bachelor's Degree preferred (Certified Professional Coder (CPC); Associate's Degree required (Medical Billing experience)). Certified Professional Coder (CPC) required EPIC Cadence, HB, PB certifications preferred Knowledge of CPT coding and ICD10 diagnosis required Ability to work and effectively multi-task in a fast-paced clinic environment with patients with developmental disabilities. Montefiore Medical Center is an equal employment opportunity employer. Montefiore Medical Center will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law. #J-18808-Ljbffr

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together. The Associate Healthcare Advocate is responsible for a range of provider relations services within Optum. The Associate Healthcare Advocate will work as an extension of the local Provider Performance Team by aligning to geographical regions, medical centers and/or physician practices that manage a high volume of membership. The Associate Healthcare Advocate under the supervision of a Director/Manager and or Mentor is responsible for the successful program implementation, compliance with network requirements, network assessment and selection, and program/product implementation. If you are located in Bronx, NY, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: • Manage provider groups in a defined market, limited to groups with less than 250 members, • Locate medical screening results/documentation to ensure the closure of gaps in care/suspect medical conditions. Will not conduct any evaluation or interpretation of Clinical data and will be supervised by licensed and/or certified staff, • Activities may include data collection, data entry, quality monitoring, HQPAF submission and chart collection activities, • Partner with your leadership team, the practice administrative or clinical staff to determine best strategies to support the practice and our members, • Utilizing data analysis, identify and target providers who would benefit from our coding, documentation and quality training and resources, • Establish positive, long-term, consultative relationships with physicians, medical groups, IPAs and Hospitals, • Provide measurable, actionable solutions to improve documentation and coding accuracy., • Anticipate customer needs and proactively develop solutions to meet them, • Optimize customer satisfaction, positively impact the closing of gaps in care and productivity, • Manage time effectively to ensure productivity goals are met, • Ability to problem solve, use best professional judgment and apply critical thinking techniques to resolve issues as they arise Adhere to corporate requirements related to industry regulations/responsibilities, • Maintain confidentiality and adhere to HIPAA requirements, • Function independently, meeting with physicians to discuss OPTUM tools and programs focused on improving the quality of care for Medicare & Medicaid Advantage Members, • Educate providers on Medicare quality programs and CMS-HCC Risk Adjustment methodology, emphasizing the importance of accurate chart documentation for proper reimbursement, • Support providers in ensuring documentation aligns with ICD-10 and CPT II coding guidelines and national standards, • Ability to travel within assigned territory (day trips) 75% of the time, • Other duties, as assigned You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: • 2+ years of healthcare experience with demonstrated knowledge of medical terminology and clinical issues, • 1+ years of experience with EMR systems, • Demonstrated knowledge of ICD-10, HEDIS, and Stars programs, • Demonstrated experience using MS Office (Excel, Word, PowerPoint) with ability to manipulate data, create documents, and deliver presentations, • Demonstrated ability to communicate, engage, and develop relationships across diverse audiences and collaborating teams (i.e., providers and internal stakeholders), • Must be able/willing to travel approximately 75% of the time in the assigned territory (Bronx NY Regional Area) as business needs dictate, • Reside within the Bronx NY Regional Area to perform daily travel requirements, • Access to reliable personal transportation to perform daily travel requirements, • Valid Driver's License and current auto insurance Preferred Qualifications: • Certified Professional Coder (CPC/CPC-A) or equivalent certification., • CRC certification, • Nursing background (LPN, RN, NP), • 2+ years of managed care experience, • Experience in a physician office, clinic, hospital, or similar medical setting, • Experience in Risk Adjustment, HEDIS/Stars, and gap closure initiatives, • Advanced proficiency in MS Excel (pivot tables, advanced functions), • Demonstrated knowledge of billing, claims submission, and coding software, • Project management experience, • Experience in provider network management, physician contracting, healthcare consulting, Medicare Advantage sales, or pharmaceutical sales, • Territory management experience *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Brellium's mission is to improve the standard of care across the US healthcare system. We've built AI-powered technology that helps healthcare providers deliver safer, higher-quality care - starting with the first real-time medical review platform built to fix clinical and compliance risks before they impact patients. Each year, 1 in 20 people in the U.S. experiences a medical diagnostic or compliance-related mistake. Most providers lack the time, staffing, and tools to mitigate these issues - so they go unnoticed, impacting care quality and increasing clinical and financial risk. Brellium is building the AI-powered platform that helps providers deliver safer, more consistent care by mitigating risk early and aligning patient visits with clinical best practices. Our goal is to give every provider in the U.S. the tools to deliver clinically excellent, data-driven care - at scale. Brellium was founded in 2021. Since then, we've grown to serve over 250,000 providers across all 50 states who use Brellium to take better care of their patients and ensure data-driven, compliant care. We're a Series A company with over $30MM in funding from First Round Capital, Left Lane Capital, and Menlo Ventures. Our coding module validates medical codes like CPT, E/M levels, and ICD-10-CM diagnoses against the underlying documentation. We're looking for a certified medical coder to code and audit outpatient encounters, and to help shape how automated, human-in-the-loop coding works at scale. You'll work alongside our senior coders and partner with Customer Success, Product, and Engineering to make sure coding decisions are accurate, defensible, and aligned with payer expectations. • Code and audit outpatient encounters, ensuring code selection is supported by the documentation, • Flag encounters where the documentation doesn't support the billed level, • Escalate complex or ambiguous scenarios and document the reasoning so our guidelines improve over time, • Give feedback on our automated coding logic surface edge cases, false positives, and gaps the platform should handle, • Contribute to internal QA, calibration sessions, training materials, and coding playbooks as the program scales Required • CPC-A or CPC certification (AAPC), • 2+ years of experience in medical coding or revenue cycle management, • Hands-on outpatient coding experience in behavioral health / psychiatry, including E/M level selection (MDM vs. time), • Strong attention to detail and sound judgment on documentation sufficiency, • Experience working with providers and other clinical stakeholders Preferred • Additional relevant credentials (e.g., CPMA, CEMC, CFPC, CCC, CANPC, CCS-P, CPB), • Experience training or calibrating other coders, • Experience with revenue cycle management and billing, • A clear communicator with clinicians, billing teams, and operational leaders, • A systems thinker who wants to improve processes, not just work a queue, • Excited to apply coding expertise in a modern, technology-driven environment We are committed to offering a comprehensive and competitive total rewards package, including robust health benefits, commuter benefits, and meaningful ownership opportunities through equity. Compensation decisions are made holistically, ensuring fairness and alignment with market benchmarks while recognizing individual contributions and potential. • 401(k) Retirement Savings Plan, • Equity Compensation, • Dinner Provided via DoorDash & stocked kitchen for NY employees, • Medical, Dental, and Vision coverage coverage of up to 100% premiums for you and your family, • HSA / FSA, • 11 paid holidays each year, • Unlimited PTO, • Training and professional development, • Hybrid Work Schedule (4 days onsite, 3 if located > 1 hour away) Bias to Action: Brellium teammates do not wait to make reversible decisions or seek unnecessary approval. We quickly decide and move forward. If the decision was incorrect, we quickly reverse it and move forward. Thinks for themselves: Brellium teammates do not take things at face value. We ask "why" until base truth is reached. If a better solution is present, Brellium teammates use it, regardless of status quo. Negative Maintenance: The opposite of high maintenance isn't low maintenance - it's negative maintenance. Brellium teammates are poised under pressure, self-motivated, self-improving, self-disciplined, self-aware, and non-defensive. Expect Excellence: We hold ourselves to exceptionally high and continuously rising standards. We strive for thoughtfulness in our decision making, and for speed and quality in our execution. We acknowledge trade-offs and communicate proactively. Communicate with Clarity: Brellium teammates communicate concisely, directly, and purposefully. We optimize for ensuring our points are easily understood the first time. We are aware of fraudulent job offers claiming to be from Brellium. All legitimate communication comes from brellium.com, or no-reply@ashbyhq.com, and we will never ask for money or sensitive personal information as part of our hiring process. If there are any questions please direct them to peter@brellium.com

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience.At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in e

Certified Professional Coder (CPC)/ Certified Outpatient Coder (COC).

The Manager, Professional Coding Quality & Education is a key leader within Health Information Management (HIM) and the Medical Group organization. This role is responsible for leading coding education and quality operations across the physician enterprise and partners closely with physician leadership, operational leaders, Compliance, Finance, Revenue Cycle, Clinical Departments, Information Technology, Clinical Documentation Integrity (CDI), and outsourced coding vendors to ensure accurate, timely, and compliant coding practices that support quality care, regulatory compliance, and optimal reimbursement. The Manager develops and implements coding education, oversees coding quality and audit programs, provides coding guidance to providers and operational leaders while promoting coding excellence through provider education, coding quality improvement, audit readiness, performance analytics, and technology optimization. This leader drives the adoption of innovative coding technologies, including computer-assisted coding (CAC), AI-enabled coding solutions, and workflow automation to improve coding performance, documentation integrity, ICD-10 specificity, and reimbursement accuracy. Bachelor's degree required. Certified Professional Coder (CPC), or equivalent professional coding certification required. Degree in Health Information Management (HIM) preferred with a RHIT or RHIA certification preferred. • Five or more years of progressive professional coding leadership experience within an integrated health system, academic medical center, or large physician enterprise., • Demonstrated experience leading professional coding quality, compliance and education initiatives, • Experience partnering with physician leadership, clinical departments, revenue cycle, compliance, finance, and information technology., • Experience managing outsourced coding vendors and vendor performance., • Experience leading and developing coding quality initiatives, provider education programs, audit response, and regulatory compliance activities., • Experience implementing coding technology, encoder software, computer-assisted coding, AI-assisted coding, and workflow optimization tools preferred., • Strong understanding of ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II, HCCs, and value-based reimbursement methodologies., • Expert knowledge of professional coding guidelines, including: ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II, Medicare, Medicaid, and commercial payer reimbursement methodologies., • Strong knowledge of federal and state regulations governing coding, billing, documentation, and reimbursement., • Strong understanding of physician documentation requirements and documentation integrity principles., • Ability to collaborate effectively with physicians, executive leadership, operational departments, clinical operations, finance, compliance, revenue cycle, clinical documentation integrity, and information technology., • Strong analytical skills with experience utilizing coding productivity, quality, reimbursement, denial, and audit data to drive operational improvements., • Demonstrated leadership in change management, process improvement, and technology implementation. The Valley Health System-Ridgewood Day (United States of America) • Medical/Prescription, Dental & Vision Discount Program (Full Time/Part Time Employees), • Group Term Life Insurance and AD&D(Full Time Employees), • Flexible Spending Accounts and Commuter Benefit Plans, • Supplemental Voluntary Benefits ( e.g. Short-term and Long-term Disability, Whole Life Insurance, Legal Support, etc.), • 6 Paid Holidays, Paid Time Off (varies), Wellness Time Off, Extended Illness, • Retirement Plan, • Tuition Assistance, • Employee Assistance Program (EAP), • Valley Health LifeStyles Fitness Center Membership Discount, • Day Care Discounts for Various Daycare Facilities Joining Valley Health System means becoming part of a dedicated team that values the highest quality of care in a supportive environment. In our commitment to high performance and reliability, we encourage and recognize exceptional individual performance through our industry leading compensation practices including a starting salary and benefits in accordance with your role, experience, education, and licensure. Actual individual salaries vary depending on these factors. The salary listed does not include other forms of compensation or benefits. Pay Range: $108,784.00 - $135,990.40 Valley Health System does not discriminate on the basis of ancestry, age, atypical hereditary cellular or blood trait, civil union status, color, creed, disability, domestic partnership, gender, gender identity or expression, familial status, genetic information, liability for service in the Armed Forces of the United States, marital status, medical condition or illness, mental or physical handicap, national origin, nationality, perceived disability, pregnancy, race, refusal to submit to genetic testing or make available results of such tests, religion, sex, sexual orientation, veteran's status or any other protected basis, in accordance with all applicable Federal, State and Local laws. This applies to all areas of employment, including recruitment, hiring, training and development, promotion, transfer, termination, layoff, compensation, benefits, social and recreational programs, and all other conditions and privileges of employment.

Sentara Health Plan is currently hiring a Fraud and Abuse Investigator/Certified Professional Coder (CPC) Remote! Status: Full-time, permanent position (40 hours) Work hours: 8am to 5pm EST, M-F Location: This position is remote for candidates that live in the following states: Virginia, North Car

Sentara Health Plan is seeking a Fraud and Abuse Investigator/Certified Professional Coder (CPC) to work remotely from eligible states.

Job DescriptionLocation: Remote Pay Rate: $30.00 per hour Employment Type: Contract Position Overview We are seeking an experienced Medical Coding & Risk Adjustment Specialist to support risk adjustment initiatives across Medicare, Medicaid, and Commercial lines of business. This role is responsible for reviewing and analyzing medical record documentation to ensure accurate diagnosis coding, proper documentation practices, and Hierarchical Condition Category (HCC) abstraction. The ideal candidate will have a strong background in medical coding, chart auditing, and risk adjustment methodologies, with expertise in ICD-10, CPT, and HCPCS coding standards. This individual will play a key role in supporting Risk Adjustment Data Validation (RADV) audits, Annual Commercial (ACA) reviews, and ongoing coding accuracy initiatives. Key Responsibilities • Review and analyze medical records to ensure documentation completeness, accuracy, and compliance with coding guidelines and regulatory requirements., • Abstract and validate Hierarchical Condition Categories (HCCs) using ICD-9/ICD-10 coding guidelines., • Translate and interpret CPT, HCPCS, ICD-9, and ICD-10 codes for risk adjustment and coding review purposes., • Identify, compile, and code member and patient information utilizing established coding classification systems., • Support Medicare Advantage, Medicaid, and Commercial Risk Adjustment programs and annual RADV audit activities., • Assist in the collection, review, and distribution of coding and documentation improvement tools., • Serve as a coding resource and subject matter expert for internal stakeholders., • Participate in process improvement initiatives and coding quality programs., • Maintain department productivity, quality, and accuracy standards., • Stay current on coding regulations, risk adjustment methodologies, and industry best practices.Qualifications Required: • Current RHIT (Registered Health Information Technician) certification OR, • Certified Professional Coder (CPC) certification through AAPC OR, • Certified Coding Specialist (CCS) certification through AHIMA, • 2-5 years of medical coding experience., • At least 2 years of experience in health insurance chart audits, quality reviews, utilization review, or risk adjustment auditing., • Strong working knowledge of:, • ICD-9 and ICD-10 coding, • CPT-4 coding, • HCPCS coding, • HCC risk adjustment methodologies, • Proficiency with Microsoft Office applications, including Word and Excel.Preferred:, • Bachelor's degree in Health Information Management, Healthcare Administration, or a related field., • Experience supporting Medicare Advantage, Medicaid, ACA, or Commercial Risk Adjustment programs.Knowledge, Skills & Abilities, • Strong understanding of medical terminology, healthcare procedures, abbreviations, and coding regulations., • Knowledge of healthcare delivery systems and insurance-related processes., • Excellent analytical and problem-solving skills., • Ability to work independently in a remote environment while collaborating effectively with a team., • Strong written and verbal communication skills., • Ability to ask probing questions, investigate discrepancies, and gather thorough documentation., • Demonstrated professionalism, ethical business practices, and commitment to continuous learning and development.Pay Details: $28.00 to $30.00 per hour Search managed by: Tracy Galarza Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable. Equal Opportunity Employer/Veterans/Disabled Military connected talent encouraged to apply To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.lhh.com/us/en/candidate-privacy The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable: • The California Fair Chance Act, • Los Angeles City Fair Chance Ordinance, • Los Angeles County Fair Chance Ordinance for Employers, • San Francisco Fair Chance OrdinanceMassachusetts Candidates Only: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Job DescriptionMedical Biller (Multispecialty Private Practice – On-Site, NYC Location: Manhattan, New York City (on-site) Salary Range: $60,000 – $80,000 per year (commensurate with experience) About the Role:A busy multispecialty private practice in New York City is seeking an experienced Medical Biller to oversee all aspects of revenue cycle management (RCM). The ideal candidate is detail-oriented, self-motivated, and skilled at optimizing reimbursement processes while maintaining accuracy and compliance. You will work closely with a team of physicians and administrative staff to ensure efficient billing operations and high-quality patient communication. Key Responsibilities:Revenue Cycle Management: • Manage the complete billing process, from patient registration to payment posting., • Ensure proper coding accuracy (CPT, ICD-10) and adherence to payer and compliance guidelines., • Handle claim submissions, denials, and appeals to reduce rejections and improve collections., • Analyze billing trends and provide regular reports to leadership on financial performance. Front Office & Documentation: • Partner with front-desk staff to ensure accurate insurance verification and patient information., • Support referral and authorization processes for procedures and testing. Billing & Collections: • Submit clean claims in a timely manner., • Monitor accounts receivable, follow up on unpaid claims, and resolve billing inquiries., • Implement strategies to improve cash flow and reduce days in A/R. Compliance & Reporting: • Stay current with billing regulations, payer requirements, and coding standards., • Generate financial reports and performance summaries for management review. Patient Communication: • Provide clear explanations of patient financial responsibilities., • Address billing concerns professionally and empathetically. Qualifications: • Minimum 3 years of experience in medical billing or revenue cycle management (private practice experience preferred)., • Strong understanding of CPT and ICD-10 coding, insurance verification, and payer guidelines., • Proficient in billing software and Microsoft Office (Excel, Word)., • Excellent communication, organizational, and problem-solving skills., • Certified Professional Coder (CPC) credential is a plus. Why Join Us: • Competitive salary commensurate with experience., • Supportive, team-oriented environment., • Direct collaboration with practice leadership., • Room for professional growth and advancement., • Opportunity to make a meaningful impact in a dynamic, patient-centered practice. To Apply: Please submit your résumé and a brief cover letter describing your relevant experience and availability.

Job Description About the job Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark, General Catalyst, Peter Thiel, Adam D'Angelo, Larry Summers, and Jack Dorsey. Position: Coding Manager / HIM Coding Leader Type: Contract Compensation: $80/hour Location: Remote Role Responsibilities • Oversee professional fee and facility inpatient coding operations to ensure accuracy, productivity, and compliance with coding guidelines., • Evaluate AI-generated coding assignments for ICD-10-CM/PCS, CPT/HCPCS, and DRG assignments to ensure accuracy and compliance., • Conduct coding quality audits and provide targeted feedback to coding staff and AI systems., • Monitor coding KPIs such as coder productivity, accuracy rates, unbilled accounts, and claim denial rates due to coding errors., • Manage coding workflow queues, work distribution, and ensure turnaround time compliance., • Collaborate with CDI, billing, and compliance teams to address coding-related revenue integrity issues., • Annotate AI-generated coding outputs and provide structured feedback to support AI training datasets. Qualifications Must-Have • 5+ years of experience in medical coding, with at least 2 years in a coding manager or HIM leadership role., • Expert knowledge of ICD-10-CM/PCS, CPT/HCPCS, and Official Coding Guidelines., • Proficiency in professional fee coding and/or facility inpatient coding with DRG assignment experience., • Experience conducting coding audits and developing coding quality improvement programs., • Proficiency with coding software (3M, Nuance, Optum360, TruCode) and EHR platforms., • Exceptional written and verbal English communication skills., • High attention to detail with the ability to identify coding errors, compliance risks, and AI output inaccuracies. Preferred • CPC (Certified Professional Coder), CCS (Certified Coding Specialist), RHIA, or RHIT credential., • Experience with computer-assisted coding (CAC) tools and NLP-based coding platforms., • Background in inpatient facility coding with DRG optimisation experience., • Familiarity with AI coding tools and comfort evaluating AI-generated coding assignments., • Experience presenting coding performance data and quality metrics to leadership. Application Process (Takes 20–30 mins to complete) • Upload resume, • AI interview based on your resume, • Submit form Resources & Support • For details about the interview process and platform information, please check: https://talent.docs.mercor.com/welcome, • For any help or support, reach out to: support@mercor.com PS: Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.

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!