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Company Description Nile Tech Inc. is dedicated to empowering professionals in achieving their career aspirations. With a focus on connecting individuals to opportunities that align with their goals, we foster growth and success. Our dynamic team and innovative solutions are designed to help clients thrive in today's evolving job market. Join us and make a meaningful impact in driving organizational and individual success. Role Description This is a full-time, on-site role located in Jersey City, NJ for a Human Resources Consultant. The consultant will work closely with clients to develop and implement effective HR strategies. Responsibilities include advising on HR policies, managing employee relations, ensuring compliance with labor and employment laws, facilitating HR management processes, and serving as a strategic partner for workforce planning and development. Key Responsibilities • Source, screen, and place IT consultants across SAP, data engineering, cloud, and related domains, • Market bench consultants (OPT, CPT, H-1B, GC, USC) to vendors and clients via job portals, LinkedIn, and direct outreach, • Build and maintain relationships with prime vendors, Tier-1 vendors, and direct clients, • Negotiate pay rates, bill rates, and contract terms with vendors and candidates, • Manage consultant profiles, submission tracking, and interview coordination, • Maintain and update ATS/CRM with candidate and vendor data, • Ensure compliance with immigration statuses (OPT, H-1B, GC, etc.) during placements, • Coordinate onboarding, offer letters, and consultant documentation, • Support HR functions including employee records, compliance, and payroll coordination

Who is Core Medical Wellness? Core Medical Wellness is redefining what meaningful healthcare feels like. We treat every person as a whole human being, not just a diagnosis. Our integrated, patient‑centered approach helps people move beyond pain and back to active, fulfilling lives. Role Summary We’re looking for a detail‑oriented Prior Authorization & Surgical Scheduling Specialist to own the process of securing insurance approvals and coordinating procedures for our pain management and regenerative medicine patients. This is a fully remote, part‑time role, Monday–Friday, with a consistent daytime schedule (approx. 15 - 20 hours per week). You’ll work closely with our clinical and front desk teams to: • Obtain timely prior authorizations and pre‑certifications, • Schedule procedures and coordinate with facilities, • Communicate clearly with patients, payers, and providers What you’ll do • Verify insurance eligibility and obtain prior authorizations for procedures, imaging, and treatments via payer portals and phone., • Review clinical documentation to determine authorization requirements., • Schedule procedures at various facilities and confirm logistics with patients., • Review patient deductibles/copays and document them in the EMR and tracking spreadsheets., • Track and appeal authorization denials when appropriate., • Answer questions from patients, internal staff, and insurance companies., • Maintain accurate, up‑to‑date records in our EMR and practice management systems., • Protect PHI at all times and adhere to all HIPAA regulations. What you bring • 1+ year experience in prior authorizations, pre‑certs, or surgical scheduling (pain management, ortho, neuro, or similar preferred but not required)., • Strong knowledge of medical terminology, CPT/ICD‑10, and payer requirements (including Workers’ Comp / Auto)., • Proven ability to work independently, manage your own queue, and hit turnaround-time targets., • Excellent written and verbal communication., • Reliable high‑speed internet, a private workspace, and comfort working in multiple software systems. What we offer • Fully remote, part‑time role (Monday–Friday, consistent daytime hours)., • Competitive hourly pay starting at $23–$27/hour depending on experience and certifications., • Training on our workflows, EMR, and payer mix., • A stable, mission‑driven team that values integrity, accountability, and continuous improvement.2. Compensation guidance for a remote hire Based on current US data for remote Prior Authorization Specialists and Surgical Schedulers, a competitive starting range for an experienced part‑time, fully remote W2 hire is: • $23–$27 per hour for someone with 1–3+ years in prior auth / surgical scheduling, • You can reserve $26–$28+ for candidates with deep pain management / Workers Comp / Auto experience or who can own the entire pipeline with minimal supervision.

Job Description Summary Location: #LI-Hybrid This role sits at the intersection of AI/ML, real-world data, digital health, and commercial pharma strategy within the Strategy, Platforms & Transformation Personalized & Precision Medicine (PPM) team. The Director will architect, develop, deploy, and scale patient identification models, HCP prioritization algorithms, and site-of-care analytics across Novartis's US portfolio. This is a multidisciplinary role requiring deep technical expertise in machine learning, hands-on implementation experience in healthcare/clinical settings, and the strategic acumen to manage external partnerships with health systems, AI/CDS vendors, real-world data aggregators, and digital health developers. The successful candidate thrives in ambiguity, operates with a high degree of independence, and brings a builder mindset to an evolving precision medicine function. This position will be located at East Hanover, NJ site and will not have the ability to be located remotely. This position will require 10% travel as defined by the business (domestic and/ or international) Job Description Key Responsibilities: • Lead end-to-end development and deployment of patient identification, HCP targeting AI/ML, ensuring clinical validity and commercial impact across therapeutic areas., • Design clinical decision support (CDS) algorithms to improve patient outcomes via accelerating time to diagnosis, and treatment leveraging real-world data sources including claims, EHR, lab, genomic, patient generated health data, and registry data. Own and advance external partnership strategies with health systems, AI/CDS vendors to integrate these algorithms into clinical workflows leading to measurable impact on clinical outcomes., • Architect scalable model lifecycle frameworks - from ideation through development, validation, deployment, monitoring, optimization, and sunsetting - ensuring governance, fairness, and reproducibility., • Navigate regulatory and compliance requirements related to AI/ML in healthcare, including FDA CDS guidance frameworks, HIPAA, and anti-kickback safe harbor considerations., • Collaborate cross-functionally with Brand/Marketing, Medical Affairs, HEOR, Legal/Compliance, Field Teams, and Patient Support to translate clinical and commercial needs into actionable AI/ML solutions., • Drive integration of advanced AI technologies including large language models (LLMs), generative AI, deep learning, and foundation models into precision medicine workflows where applicable., • Develop go-to-market frameworks and field activation resources that enable model-adjacent materials for commercial teams to act on model outputs., • Champion a culture of experimentation, continuous improvement, and scientific rigor - contributing to peer-reviewed publications, conference presentations, and open-source model externalization where appropriate., • Operate with a high level of autonomy and self-direction, proactively identifying opportunities, managing ambiguity, and driving initiatives forward without close supervision., • Serve as a thought leader within Strategy, Platforms & Transformation and across the Novartis US organization on the convergence of AI, real-world data, and precision medicine in commercial pharma. Essential Requirements: • Master's degree required; PhD or doctoral degree preferred. Relevant fields: Data Science, Computer Science, Bioinformatics, Health Informatics, Computational Biology, Statistics, Epidemiology, or related quantitative/health sciences discipline. Clinical or health-focused education or research background is a plus., • Minimum 10+ years of experience in data science, AI/ML, or digital health, with at least 5 years in pharmaceutical, medical device, health-tech, or digital health settings., • Demonstrated hands-on expertise building and deploying machine learning models (classification, NLP, deep learning, recommendation systems) using Python, Spark, TensorFlow, PyTorch, or equivalent., • Experience designing and executing model validation frameworks - ensuring accuracy, reliability, clinical validity, and reproducibility of AI/ML algorithms prior to clinical or commercial deployment, • Proven experience with cloud-based ML infrastructure (AWS, Azure, GCP) for scalable model deployment., • Deep working knowledge of healthcare data: EHR (structured and unstructured), medical/pharmacy claims, lab results, genomic data, and patient registries., • Working knowledge of clinical terminologies and coding systems (e.g., ICD-10, SNOMED CT, LOINC, RxNorm, CPT) used in model feature engineering and clinical data interpretation, • Proven ability to communicate complex AI/ML concepts and strategies to senior executive leadership and non-technical audiences, translating technical outputs into business value narratives., • Experience implementing or partnering on AI/ML solutions in clinical or healthcare delivery settings, including clinical decision support integration into EHR workflows., • Track record managing external partnerships with health systems, AI/CDS vendors, EHR platforms, data aggregators, or digital health companies., • Working knowledge of regulatory and compliance landscape for AI in healthcare: FDA CDS frameworks, HIPAA, anti-kickback statutes., • Experience working in complex, matrixed organizational environments with demonstrated ability to influence without authority across commercial, medical, legal, and technical stakeholders., • Knowledge of large language models (LLMs) such as GPT, BERT, Cohere, and their practical applications in healthcare and commercial pharma. Desirable Requirements: • External thought leadership (publications, conference presentations, industry working groups) is a plus. Novartis Compensation Summary: The salary for this position is expected to range between $194,600.00 and $361,400.00 per year. The final salary offered is determined based on factors like, but not limited to, relevant skills and experience, and upon joining Novartis will be reviewed periodically. Novartis may change the published salary range based on company and market factors. Your compensation will include a performance-based cash incentive and, depending on the level of the role, eligibility to be considered for annual equity awards. US-based eligible employees will receive a comprehensive benefits package that includes health, life and disability benefits, a 401(k) with company contribution and match, and a variety of other benefits. In addition, employees are eligible for a generous time off package including vacation, personal days, holidays and other leaves. EEO Statement: The Novartis Group of Companies are Equal Opportunity Employers. We do not discriminate in recruitment, hiring, training, promotion or other employment practices for reasons of race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, marital or veteran status, disability, or any other legally protected status. Accessibility and reasonable accommodations The Novartis Group of Companies are committed to working with and providing reasonable accommodation to individuals with disabilities. If, because of a medical condition or disability, you need a reasonable accommodation for any part of the application process, or to perform the essential functions of a position, please send an e-mail to us.reasonableaccommodations@novartis.com or call +1(877)395-2339 and let us know the nature of your request and your contact information. Please include the job requisition number in your message. Salary Range $194,600.00 - $361,400.00 Skills Desired Agile (Programming Methodology), Artificial Intelligence (AI), Business Value Creation, Change Management, Curious Mindset, Data Governance, Data Literacy, Data Quality, Data Science, Data Strategy, Data Visualization, Deep Learning, Learning Agility, Machine Learning (ML), Machine Learning Algorithms, Mentorship, Nlp (Neuro-Linguistic Programming) And Genai, Organization Awareness, Stakeholder Engagement, Statistical Analysis, Time Series Analysis, Vision, Visualization

Job Description Your Future as a BCBA Starts Here—And It’s Looking Bright Join the largest female clinician-led ABA agency in the country and work with people who just get it. At Autism Learning Partners, we’re all about growing together, learning from each other, and actually making a difference! Whether you're fresh in the field or leveling up, you'll find mentorship, career growth, and a whole community of BCBAs ready to cheer you on! What We’re Offering: • Total 1st year Earning Potential: $110,000+ in your first year including bonuses!, • Base Salary: $82,000 to $100,000 based on experience, skills, and geography Initial Onboarding Support: 60+ hours of comprehensive training during the first 3-4 weeks of integration including topics such as clinical best practices, using Central Reach, goal writing, clinical problem solving, CPT codes, telehealth assessments. Our Clinical Development team also offers weekly office hours or 1:1 support, as needed. Education and Mentorship: Monthly CEUs, annual in-house conference featuring leading researchers in the field, and opportunities to lead sponsored research initiatives Some Benefits Highlights: 23 days off annually between holidays including 1 floating holiday and 15 days of PTO that begins to accrue from Day 1 Flexible Schedule: Opportunities to work from home that includes Mon-Fri flexibility in the mornings and afternoons. No expectation of Saturday work unless you want to schedule make-up sessions. You’re in full control! Our Promise: We don't require contracts or non-compete agreements because we value flexibility and trust. Your employment with us is fully at-will, allowing you to grow with us on your own terms. Why Choose Us? An org chart of nothing but BCBAs between you and the CEO, Dr. Gina Chang, BCBA-D. A clear path to make values-based clinical decisions based entirely on what is best for your client and family Generous health insurance package, 401(k) Retirement Program with employer match, and employer paid short-term disability As a CASP Provider, ALP will grant you access to CASP’s entire CEU library which includes over 75 CEU-approved courses (plus 10 CEUs annually via ALP events such as our IMPACT Conference and monthly live sessions) Clear promotion framework from BCBA, Sr. BCBA, Assistant Clinical Director, Clinical Director, and Senior Clinical Director For any new BCBA certificants – we offer the 8-hour supervision course as approved by the BACB Unlimited referral bonuses Reasonable expectation of billable hours Opportunity to partner and/or serve with our internal DEI council Study support for BCBA candidates and in-house RBT courses to help ensure your team is fully prepared Support Center resources designed to address your administrative needs, including client intake, recruiting, payroll, HR, billing, credentialing/contracting, and scheduling What You’ll Be Doing: Lead by Example and Be a Pillar of Support: Inspire and guide Behavior Technicians through effective supervision and support, ensuring that they are implementing treatment plans with a high degree of reliability and fidelity. Drive Positive Change: Conduct FBAs and develop innovative ABA programs that include continuously evaluating client needs, providing parent education, and problem solving, to help each client reach their potential. Embrace Challenges with Grace: Stay calm and professional in challenging situations, adapt to change with flexibility, and continuously seek opportunities for growth. Lead with Initiative and Openness: Proactively communicate, take initiative, and welcome learning to create a safe environment for collaboration and knowledge sharing. Place applicable "What We're Looking For" section (Delete this note after section is placed) What We’re Looking For: • Certification as a Board Certified Behavior Analyst (BCBA) with the Behavior Analyst Certification Board (BACB), • Active LBA Certification in the state of New Jersey as issued by the State Board of Applied Behavior Analyst Examiners, • Please note that this position is subject to a criminal background check, TB test, Pre-employment Physical Exam, which we will pay for Autism Learning Partners supports a diverse workforce and is an Equal Opportunity Employer. At Autism Learning Partners, we understand that culture is the foundation of who we are as a company and how we serve our clients, families, and employees. We are one of the nation's leading full-service ABA providers specializing in the treatment of autism and other developmental disabilities. Our broad thinking approach addresses the whole child by collaborating with doctors, therapists, families, schools, and specialists. Our goal is to work together to achieve the best possible outcome and progress through our commitment to Diversity, Inclusion, and Equity, which includes forming a DEI council, monthly trainings for senior clinical staff, national trainings, a monthly DEI newsletter, continual updates to our email signatures, education on topics like generational trauma and trauma-informed care, and always striving to provide the best care and comfort for our clients, families, and employees. EWRBACR102

Job Description We are looking for an experienced Pediatric Office Manager to ensure the smooth operation of our practice. Responsibilities include overseeing front desk and clinical staff, optimizing workflows, and maintaining high standards of patient care. • Setting: Outpatient Pediatric Clinic - Privately owned, • Schedule: Monday-Friday, • Hours: 8am-6:30pm with Saturday rotations, • Compensation: $50-65k, • Start Date: ASAP Key Responsibilities: • Manage front desk operations and supervise staff., • Implement processes to improve efficiency and productivity., • Collaborate with clinical staff to streamline workflows and ensure accurate EMR documentation., • Coordinate with the Senior Biller on coding and financial matters., • Ensure adherence to PCMH/NCQA guidelines. Requirements: • Knowledge of insurance plans, ICD-10, CPT coding, and billing software., • Clinical skills in patient care and vital signs., • Strong organizational and leadership abilities with experience in supervising staff., • Ability to work independently and efficiently., • Must have a Medical Degree, such as CMA, RN, or LPN., • Must have minimum 3-5 years of experience in Pediatric experience About Us: HealthPlus Staffing is National Leader in the Healthcare Staffing Industry. We partner up with top facilities nationwide with the focus of finding them highly qualified candidates. Our Promise: • We will put you in front of the decision makers., • We will provide feedback on your application., • We will work on your behalf to obtain as much info as you need to make a well-informed decision. If interested in this position, please submit an application or call us at 561-291-7787 to speak with one of our highly experienced consultants. We look forward to finding your next position! The HealthPlus Team.

Job DescriptionDescription: About Us Union County Orthopaedic Group, a division of OrthoNJ, LLC, is a fast-paced, patient-centered practice specializing in orthopaedics, pain management, and podiatry across three convenient New Jersey locations. We are looking for a detail-oriented, experienced Billing & Collections Specialist to join our billing team and play a key role in the financial health of our practice. Position Overview The Billing & Collections Specialist is responsible for the timely follow-up of rejected claims, unpaid insurance balances, and patient accounts receivable. This role requires a strong understanding of the revenue cycle in a physician group practice setting, the ability to build productive relationships with commercial payors, and a commitment to accuracy, confidentiality, and professionalism. Requirements: What You'll Do • Follow up on rejected and unpaid insurance claims using EOB forms, aged A/R reports, and payor portals; initiate follow-up on claims 45+ days outstanding, • Reprocess paper and electronic claims for assigned carriers; review and resolve clearinghouse edit reports daily, • Post adjustments, withholds, deductibles, and coinsurance transfers; submit balanced payment batches daily, • Appeal payments that do not align with contractual agreements; partner with the Billing Manager on persistent payor issues and denial language, • Manage patient accounts, including payment plan setup, statement processing, collection letter generation, and outside agency referrals, • Respond to written and phone inquiries from patients and insurance carriers with professionalism and accuracy, • Verify patient eligibility and benefits; ensure all account information is current and accurate, • Monitor monthly payor policy/guideline updates and report relevant changes to the Billing Manager, • Scan and document all correspondence, appeals, and actions taken in the practice management system, • Process requests for insurance and patient refunds, submitting to the Billing Manager for approval, • Support the team with payment posting (including in-absence coverage) and general billing office functions What We're Looking For • Minimum 2 years of revenue cycle experience in a physician group practice billing department — required, • Orthopaedic billing experience — required, • Commercial insurance billing experience (e.g., BCBS, Aetna, Cigna, UHC) — required, • Familiarity with CPT and ICD-10-CM coding for orthopaedic, podiatry, and pain management procedures, • Working knowledge of practice management systems and electronic medical records (ModMed/EMA experience a plus), • Strong analytical skills with exceptional attention to detail, • Excellent verbal and written communication skills, • Bilingual (English/Spanish) a plus — our patient population includes Spanish-speaking patients and the ability to communicate in both languages is highly valued, • Ability to work collaboratively with physicians, clinical staff, patients, and insurance representatives, • Knowledge of HIPAA and OSHA guidelines, • HS diploma or GED required Why Join the UCOG Division of OrthoNJ, LLC? We offer a supportive, team-oriented environment where your expertise is valued and your contributions make a direct impact. Join a practice that takes pride in delivering exceptional patient care — and equally exceptional support behind the scenes. Union County Orthopaedic Group is an equal opportunity employer. OrthoNJ, LLC is required by New Jersey law to include the salary range for this role. The hiring range for this role is $18-30 hourly. The range for this role is typically determined by several factors, including the geography in which the selected candidate will be working, and alignment with qualifications and experience. Certain roles may also be eligible for additional compensation (bonus, etc.) and/or benefits. In addition, full-time employees are eligible for standard benefits package including paid time off, medical, dental, vison and retirement plan.

Job DescriptionDescription: About Us Union County Orthopaedic Group, a division of OrthoNJ, LLC, is a fast-paced, patient-centered medical practice specializing in orthopaedics, pain management, and podiatry across three convenient New Jersey locations. We are seeking an experienced Billing Supervisor to lead our billing team, drive revenue cycle performance, and ensure the accuracy and efficiency of our billing operations. Position Overview The Billing Supervisor is responsible for overseeing the day-to-day workflow of the billing department, including follow-up on rejected claims and overdue balances, payor relationship management, and patient accounts receivable. This role is both a hands-on operational position and a people leadership role — requiring someone who can coach and develop staff while also rolling up their sleeves to keep the revenue cycle running smoothly. Requirements: What You'll Do Leadership & Supervision • Assist with recruitment, discipline, and termination of Reimbursement and Patient Collections staff, • Train, develop, and oversee the performance of billing team members; conduct regular one-on-ones to address key issues, A/R performance, and growth opportunities, • Monitor overall department workload and distribute work accordingly; ensure coverage during vacations and absences, • Provide in-service training to staff on insurance requirements and billing updates Revenue Cycle Operations • Maintain working knowledge of all key billing functions including claims processing, payment posting, insurance follow-up, and patient collections, • Analyze aged A/R reports, days in receivable, and collection statistics by payor; present findings to physicians as needed, • Perform quarterly billing audits to ensure timely and accurate charge and payment posting, • Conduct quarterly reviews of EOB forms from commercial and managed care payors, • Meet with physicians to discuss complex or difficult claims, • Monitor patient payment plan adherence and intervene as needed, • Identify opportunities to leverage technology for operational improvements Reimbursement & Managed Care • Maintain and update the practice fee schedule, CPT, ICD-10-CM, adjustment, and payment codes, • Maintain and distribute contracted payment schedules from carriers; input/update into the practice management system, • Request updated payment schedules from contracted carriers annually and prepare quarterly fee/payment comparative reports, • Maintain carrier contracts and assist with credentialing applications and reapplications as requested, • Distribute formularies to clinicians and stay current on specialty, Medicare, Medicaid, and carrier updates Compliance & General • Uphold HIPAA compliance standards; report identified or suspected violations to the Privacy Officer, • Maintain coding compliance standards; actively participate on or support the Compliance Team, • Maintain detailed knowledge of practice management systems and EMR as it relates to job functions, • Attend staff meetings and continuing education sessions as required What We're Looking For • Minimum 2 years of medical office management experience, preferably in a physician group practice — required, • Revenue cycle experience in a physician group practice setting — required, • Orthopaedic billing experience — required, • Commercial insurance billing experience (e.g., BCBS, Aetna, Cigna, UHC) — required, • Proven knowledge of CPT and ICD-10-CM coding for orthopaedic, podiatry, and pain management procedures, • Strong understanding of managed care contractual arrangements and accounts receivable processes, • Working knowledge of practice management systems and electronic medical records (ModMed/EMA experience a plus), • Strong analytical skills with the ability to interpret and present A/R data, • Excellent verbal, written, and interpersonal communication skills, • Bilingual (English/Spanish) a plus — our patient population includes Spanish-speaking patients and the ability to communicate in both languages is highly valued, • Knowledge of HIPAA and OSHA guidelines, • HS diploma or GED required; Bachelor's degree in Business or related field preferred Why Join the UCOG Division of OrthoNJ, LLC? We offer a collaborative, supportive environment where strong performers are recognized and leadership is valued. If you're an experienced billing professional ready to take ownership of a department and make a meaningful impact, we'd love to hear from you. Union County Orthopaedic Group is an equal opportunity employer. OrthoNJ, LLC is required by New Jersey law to include the salary range for this role. The hiring range for this role is $62k-$80k annually. The range for this role is typically determined by several factors, including the geography in which the selected candidate will be working, and alignment with qualifications and experience. Certain roles may also be eligible for additional compensation (bonus, etc.) and/or benefits. In addition, full-time employees are eligible for standard benefits package including paid time off, medical, dental, vison and retirement plan.

Job Description New Jersey’s largest Vascular Surgery group dedicated solely to the diagnosis and management of diseases of the arteries and veins. The Group has been delivering care throughout New Jersey since 1963 and is home to some of the best Vascular Surgeons in the country. Consistently recognized by their peers and patients as the top group in the region, The Cardiovascular Care Group provides the highest quality care using the newest technologies in the setting of years of experience with outstanding results. Position Summary: We are seeking an experienced Senior Vascular Surgery Professional Coder with strong expertise in complex open and endovascular procedure coding, payer authorization workflows, and revenue cycle support. This role is responsible for accurate CPT, ICD-10-CM, and modifier assignment for a high-volume vascular surgery practice with extensive cardiovascular, endovascular, catheter-based, and imaging-guided procedural work. The position also supports prior authorization and medical necessity review processes for vascular and interventional procedures. The ideal candidate possesses advanced knowledge of: • Vascular surgery coding, • Endovascular intervention coding, • Interventional Radiology coding, • Catheterization hierarchies, • Radiology supervision & interpretation (S&I), • Global surgery rules, • NCCI edits, • Modifier usage, • Payer authorization requirements, • Medicare/commercial payer policies This position requires independent review and coding of highly complex operative reports and procedural documentation across hospital, ASC, office, and interventional settings. Senior Vascular Surgery Professional Coder Core Responsibilities: Professional Coding Responsibilities • Review and accurately code complex vascular surgery operative reports, procedure notes, and E&M encounters, • Assign CPT, HCPCS, ICD-10-CM, and modifiers in accordance with AMA, CMS, NCCI, and payer-specific guidelines, • Interpret and code:, • open vascular procedures,, • endovascular interventions,, • angiography,, • catheter placements,, • thrombectomy,, • bypass grafting,, • dialysis access procedures,, • embolization,, • stent placement,, • EVAR/TEVAR,, • and hybrid vascular procedures, • Apply correct selective catheterization hierarchies and vascular family rules, • Code radiology S&I services appropriately, • Review operative documentation for completeness and compliance, • Query providers for clarification when documentation is insufficient, • Identify coding opportunities, missed charges, and undercoding trends, • Resolve coding edits and claim rejections related to vascular procedures, • Support denial management and payer audit responses, • Maintain productivity and accuracy standards for high-complexity vascular coding, • Collaborate with physicians, billers, auditors, and revenue cycle leadership, • Stay current on annual CPT, CMS, and payer policy updates impacting vascular surgery Prior Authorization & Medical Necessity Responsibilities: • Obtain and manage prior authorizations for vascular surgery, endovascular, imaging, and interventional procedures, • Verify medical necessity requirements based on payer policies and LCD/NCD guidelines, • Submit supporting clinical documentation for authorization requests, • Track authorization status and ensure approvals are obtained prior to scheduled procedures, • Communicate authorization requirements and updates to providers, schedulers, and clinical staff, • Assist with peer-to-peer coordination and payer follow-up when necessary, • Review denials related to authorization or medical necessity and support appeal preparation, • Maintain accurate authorization documentation within the EHR and billing systems Senior Vascular Surgery Professional Coder Required Qualifications: • Minimum 3–5 years of dedicated vascular surgery coding experience, • Extensive experience coding:, • open vascular surgery,, • interventional vascular procedures,, • angiography,, • and radiology S&I services, • Prior authorization experience within surgical or interventional specialties, • Strong understanding of:, • CPT,, • ICD-10-CM,, • HCPCS,, • NCCI edits,, • modifier usage,, • global surgery rules,, • medical necessity criteria,, • and payer reimbursement methodologies, • Ability to independently interpret highly complex operative reports, • Experience with EMR/EHR and encoder software, • Strong analytical and critical thinking skills, • Excellent written and verbal communication skills Senior Vascular Surgery Professional Coder Preferred Qualifications: • CPC, CCS-P, CIRCC, or equivalent coding certification, • CCS & CIRCC strongly preferred, • Experience in vascular surgery, interventional radiology, or cardiovascular surgery specialty coding. General Surgery a plus., • Experience with Medicare and commercial payer audits, • Experience in academic or high-volume multispecialty vascular practices Preferred Experience: • Experience with:, • Aprima EHR, • Epic, • Microsoft Excel, • Familiarity with reporting, reconciliation, and spreadsheet analysis Senior Vascular Surgery Professional Coder Productivity & Performance Expectations: • Maintain high coding accuracy in a complex vascular surgery environment, • Meet established coding turnaround and lag-day expectations, • Demonstrate proficiency with:, • modifier assignment,, • procedural bundling logic,, • selective catheterization hierarchy,, • and endovascular coding guidelines, • Maintain timely authorization turnaround and documentation accuracy, • Participate in ongoing education and specialty coding updates Senior Vascular Surgery Professional Coder Ideal Candidate Profile The ideal candidate is a highly experienced vascular surgery coder capable of independently coding complex open and endovascular operative cases while also supporting prior authorization workflows, payer compliance, and revenue cycle optimization in a fast-paced specialty practice environment.

Job Description Overview: Demonstrate competency as a claims resolution specialist for a large-scale multi-specialty/multi-site healthcare organizations in the U.S. • Perform claims resolution or medical billing and appeals or claims denials in Athena within the last two years., • Conduct AR Follow-up both on front end scrubs and back end denials through best practices. Scrub charges for submission and launch appeals via the Athena billing platform., • Review and clear claim edits in the system. Types of edits to be worked include registration, insurance, charge, and related issues for high volume practices., • Demonstrate a detailed understanding of how to read and interpret EOB's and denials from all insurance carriers (including the financial components such as co-pays, deductibles, and co-insurance)., • Possess a thorough knowledge of appeals processing from end to end across all payer categories based on insurance denials., • Differentiate between best practices of appeal, coding review, credentialing review and/or adjustment., • Contact insurance companies and utilize web portal and websites for appeal, eligibility, remittance, and payment information., • Candidate must be able to report and communicate issues and trends., • Meet or exceed daily productivity benchmarks. Knowledge, Skill, and Experience Requirements: • 3+ years of experience in claims resolution or medical billing., • A minimum of 3 years of documented experience on the Athena billing platform is required., • Working knowledge of CPT, ICD-10, and medical terminology., • Complete understanding of follow-up processes., • Solid background in AR and overall Revenue Cycle policies and procedures., • Experience working in a physician billing environment., • Excellent communication skills., • Proficiency in Microsoft Office Suite, including Word and Excel.

Job Description Position overview: The Coding Specialist I is responsible for independently reviewing, analyzing, and resolving all assigned front-end claims to ensure accurate and timely claim submission. This position focuses on identifying and correcting coding-related issues prior to claim transmission, applying established coding guidelines, payer requirements, and organizational policies. The Coding Specialist I works closely with revenue cycle partners to prevent claim rejections, support clean claim rates, and promote efficient reimbursement processes. This role requires strong attention to detail, foundational coding knowledge, and the ability to work independently in a fast-paced environment. Essential Functions: • Averages 10 front-end holds per hour, • Maintains a minimum of 90% coding accuracy., • Assigns ICD-10-CM and CPT codes with appropriate modifiers for services provided in the professional fee environment., • Reviews medical records and all applicable documentation to determine appropriate codes for documented services and diagnoses., • Ensures all diagnosis codes meet local and national medical necessity guidelines., • Utilizes internal coding resources, payer guidelines, and other reference materials to ensure accurate and compliant coding for all assigned services., • Follows all HIPAA regulations and upholds the highest standards of privacy and confidentiality., • Maintains current knowledge of laws, regulations, payer policies, and industry guidance impacting compliant coding practices., • Independently reviews and resolves all assigned front-end claim holds., • Actively participates in department meetings, one-on-one meetings, and mentorship meetings with the assigned Coding Team Lead., • Escalates identified client trends to the assigned Coding Team Lead., • Escalates all coding-related questions to the assigned Coding Team Lead for guidance and clarification., • Maintains and completes all CEU requirements., • Performs other duties or tasks as assigned. PREFERED SKILLS & EXPERIENCE • Must hold a current AAPC or AHIMA Certification for a minimum of 3 years., • Strong working knowledge of CPT, ICD-10-CM, medical terminology, anatomy and physiology, and state and federal Medicare reimbursement guidelines., • Familiarity with proper English grammar, usage, and professional documentation standards., • Ability to research and analyze data, draw logical conclusions, and resolve coding or documentation issues., • Ability to read, interpret, and apply policies, procedures, laws, and regulations., • Ability to accurately read and interpret medical documentation, clinical terminology, and documented procedures., • Demonstrated ability to exercise independent judgment in coding and claim resolution., • Excellent written and verbal communication skills, including the ability to prepare reports, clarify documentation needs, and maintain collaborative working relationships with physicians and staff., • Strong commitment to maintaining confidentiality and safeguarding protected health information., • Prior experience working in a medical billing environment with strict adherence to HIPAA compliance requirements., • Demonstrated proficiency in Microsoft Office Suite (Word, Excel, Outlook, Teams)., • Minimum of 3+ years of professional coding experience. Work environment: • Standard business office environment with moderate noise levels., • Requires extended periods of computer and monitor use., • Ability to lift and move up to 30 pounds on a non-routine basis., • Ability to sit for extended periods while performing coding and claim review tasks., • Frequent handling, including seizing, holding, grasping, and fingering objects, tools, and controls., • Close vision required to read medical documentation, electronic health records, and coding resources., • Hearing ability sufficient to receive and interpret detailed information through oral and telephonic communication.

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 Description Join Owen Health Care, a leader in health care services, as a Full-Time/Part-Time ABA/Behavioral Health Billing Specialist in Vauxhall, NJ. This is an exciting opportunity for experienced billers in the behavioral health field to contribute to a compassionate and innovative organization committed to excellence. You will be part of a dynamic and professional team where your skills will enhance our customer-focused approach. Working onsite ensures that you collaborate closely with our professional team, fostering a high-performance environment that values integrity and forward-thinking solutions. Experience the satisfaction of contributing to exceptional patient care while streamlining billing processes that support our mission. Your expertise will directly impact the quality of services we provide. As a team member you'll be offered competitive pay along with an employee benefits package that inclues: Medical, 401(k), and Paid Time Off. If you are ready to make a meaningful difference in the behavioral health landscape, we welcome your application. Owen Health Care: Our Mission Owen Health Care is a state-licensed agency and is accredited by The Joint Commission as a health care agency. We provide compassionate, quality, and affordable health care services to adults with mental health, substance abuse, and co-occurring disorders, as well as to all individuals with disabilities-including children and the elderly. In our organization, we are passionate about helping people, dedicated to the health and well being of all the clients we serve, and committed to ensuring the best quality of care. Our licensed clinicians and highly qualified professionals are trained to provide the highest quality, compassionate care. Your role as a ABA/Behavioral Health Billing Specialist As a Full-Time/Part-Time ABA/Behavioral Health Billing Specialist at Owen Health Care, you will play a crucial role in managing the billing process for ABA and behavioral health services. Your responsibilities will include submitting claims through CentralReach, Waystar, and Simple Practice, ensuring accurate and timely reimbursements. You will also post ERAs and reconcile payments with deposits, actively managing accounts receivable and working to reduce aged AR over 60 and 90 days. A key part of your role is to resolve claim denials and communicate effectively with payers to expedite reimbursements. Additionally, you will track client authorizations, notifying clinical staff of renewals, and produce KPI reports for management review. Your ability to document workflows and implement process improvements will contribute to the overall efficiency of the department, while cross-training backup staff enhances team collaboration. Join us in advancing our mission of excellence in patient care. Requirements for this ABA/Behavioral Health Billing Specialist opportunity To excel as a Full-Time/Part-Time ABA/Behavioral Health Billing Specialist at Owen Health Care, you will need a robust skill set tailored for the nuanced demands of billing in the behavioral health sector. A minimum of 2 years of experience in ABA or behavioral health billing is essential, along with proficiency in software tools like CentralReach, Simple Practice, and various clearinghouse systems. A strong understanding of Medicaid, DDD, DCF, and private insurance billing processes is critical, as well as familiarity with ABA CPT codes, modifiers, and documentation requirements. The ideal candidate will be detail-oriented and organized, demonstrating proactive problem-solving abilities and strong communication skills. Additionally, experience with government contracts, billing audits, and revenue cycle management will further enhance your effectiveness in this role. Your ability to meet deadlines while maintaining quality will be invaluable in supporting our mission of excellence in patient care. Are you ready for a growing opportunity? If you feel that this job is what you're looking for, applying is simple - just follow the instructions on this page. We look forward to hearing from you! Job Posted by ApplicantPro

Job DescriptionBilling Coordinator / Coder – Ambulatory Schedule: Full-time, Days Job Type: Permanent w/ Benefits Job Summary The Billing Coordinator / Coder is responsible for coordinating the day-to-day billing operations of the department and supporting outpatient billing services utilizing a centralized medical information system. This position is responsible for accurately abstracting data following ICD-10-CM, CPT, and HCPCS coding guidelines and directives. The role also performs data entry of required patient information into the electronic medical record system and communicates with physicians when appropriate. Essential Job Functions • Coordinate pertinent information from patient medical records for submission to the physician billing service, • Verify patient insurance and act as a liaison regarding charges, billing inquiries, and outstanding balances, • Ensure proper receipt of authorizations/referrals and completion of all required forms, • Analyze medical records and identify documentation deficiencies, • Monitor coding and billing corrections on a daily basis, • Assign CPT, HCPCS, and ICD-10-CM codes accurately, • Assess clinical documentation and communicate with providers regarding missing or incomplete information needed for proper coding, • Address coding edits and reimbursement-related documentation requirements, • Maintain required productivity and quality standards, • Comply with organizational policies, procedures, and standards of behavior, • Report unusual circumstances, risk factors, errors, and discrepancies to management, • Perform additional duties and special projects as assigned Qualifications, • High School Diploma or GED required, • Minimum of 1 year of coding or professional billing experience preferred, • Knowledge of medical terminology, anatomy, and physiology, • Strong computer proficiency including typing accuracy and speed, • Excellent written and verbal communication skills, • Proficiency in Microsoft Office and Google Suite platforms Preferred Experience, • Outpatient hospital ICD-10 diagnosis, CPT procedural, and E&M coding experience preferred Certifications, • Certified Coding Specialist (CCS), Certified Outpatient Coder (COC), Certified Professional Coder (CPC), or equivalent certification preferred, • AHIMA or AAPC credential preferred Equal Opportunity Employer: We are committed to creating an inclusive and diverse workplace. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, age, or any other legally protected characteristic. Applicants must be authorized to work in the United States. Employment may be contingent upon successful completion of background checks, reference checks, and any required screenings in accordance with applicable laws and client requirements.

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