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Job Description JOB SUMMARY The Clinical and Billing Auditor is responsible for the oversight and management of auditing and monitoring activities across the organization. Using a unique combination of clinical expertise and billing knowledge, this role monitors and improves the quality of clinical and financial documentation related to patient services. The auditor compares clinical and financial records to ensure that provided documentation supports the charges listed, helping to mitigate errors, prevent fraud, and optimize appropriate reimbursement. ESSENTIAL JOB FUNCTIONS: List all essential job duties. (To perform this job successfully, an individual must be able to perform each essential duty listed satisfactorily with or without a reasonable accommodation. Reasonable accommodations may be made to enable qualified individuals with a disability to perform the essential duties unless this causes undue hardship to the agency.) • Reviewing Documentation: Audit clinical documentation, treatment plans, and progress notes as well as utilization reviews to ensure accuracy, completeness, and compliance with billing requirements, regulatory & quality standards, and diagnostic criteria for ICL outpatient programs., • Monitoring Program Effectiveness: Evaluate the effectiveness of mental health and intellectual disabilities programs in achieving desired outcomes, such as symptom reduction, functional improvement, and enhanced quality of life for individuals served. Identify opportunities for program enhancement based on audit findings and performance metrics., • Assessing Clinical Quality: Evaluate the quality and appropriateness of clinical care provided to individuals with mental health conditions. including assessment, diagnosis, treatment planning, and therapeutic interventions. Ensure adherence to evidence-based practices and ethical standards., • Identifying Training Needs: Identify training needs and provide education and support to clinicians, staff, and providers on topics related to billing compliance, documentation standards, diagnostic criteria, treatment modalities, and best practices in ICL outpatient programs., • Collaborating with Multidisciplinary Teams: Participation in managing clinical risks in the agency by participating in Incident Review Committee Meetings, High Risk Meeting, and Sentinel Reviews, Psychiatric Medical At-Risk Case conference. Work collaboratively with clinical teams, including psychiatrists, psychologists, social workers, therapists, and case managers, to ensure coordinated and integrated care for the clients with ICL outpatient programs and intellectual disabilities. Participation in managing clinical risks in the agency by participating., • Risk Management & Compliance Oversight: Identify high risk areas for fraud, waste and abuse. Escalate significant compliance concerns. Support organizational readiness for external audits, payer investigations., • Rate & Billing Accuracy Validation: Ensure correct application of fee schedules and rate codes. CPT/HCPCS codes (where applicable. Cross-check billed services against Program type, staff credentials, service duration, and monitor adherence to payer-specific billing requirements., • Regulatory Recovery and Risk Mitigation: Consult with division administrators to develop and execute quality improvement plans, including plans of corrective action (POCAs) for certification visits and internal agency audit reports., • Operational Integration: Participate in program planning projects and meetings to provide inputs on development of quality control and program evaluation elements; and conduct or participate in management meetings with service-delivery staff to establish, delineate, and review program organizational policies, to coordinate functions and operations between departments , and establish responsibilities and procedures for attaining objectives and assist with the implementation of new programs., • Staying Informed: Stay updated on changes in healthcare regulations, billing requirements, reimbursement policies, and quality assurance standards relevant to mental health and intellectual disabilities services. Maintain knowledge of emerging trends, research findings, and best practices in the field., • Perform other related duties as assigned. ESSENTIAL KNOWLEDGE, SKILLS AND ABILITIES: • Committed to the active promotion of ICL values and goals., • Demonstrated mastery of ICD-10-CM, CPT, and HCPCS codes., • Proficiency in Electronic Health Records (EHR) systems and advanced Microsoft Excel skills for data analysis., • A solid understanding of HIPAA, Medicaid/Medicare billing rules, and documentation standards., • Knowledge of relevant industry regulations and compliance standards to ensure adherence to legal and ethical guidelines., • Ability to collaborate effectively with individuals at all levels of the organization., • Ability to educate staff on compliance issues and quality improvement continuous measures., • Strong organizational skills to manage multiple audits, prioritize tasks, and meet deadlines., • Excellent verbal and written communication skills., • Ability to identify risks related to client safety, compliance, and quality of care., • Ability to analyze information objectively and form a reasoned judgment., • A keen eye for detail for identifying inconsistencies, errors, and areas of non-compliance., • Ability to make sound judgments and decisions based on evidence and analysis., • Ability to adapt and willing to learn new techniques and technologies. QUALIFICATIONS AND EXPERIENCE: Master’s degree in social work, or Psychology, or related field plus 2 years’ experience in a clinical or human services environment conducting assessments or evaluations, performing quality assurance work, or managing programs. Certification: CPMA (Certified Professional Medical Auditor) or CHC (Certified in Healthcare Compliance) or CPB (Certified Professional Biller) designation strongly preferred. #ICLOTHER

Job DescriptionBenefits: • 401(k) matching, • Bonus based on performance, • Competitive salary, • Employee discounts, • Opportunity for advancement, • Paid time off, • Profit sharing, • Signing bonus, • Training & development, • Vision insurance Seeking experienced medical coder and biller for chain of optical stores performing medical optometry. We are looking for someone that has worked specifically or has experience in Optical coding / billing to join our team in a fast paced working environment. We offer career development and substantial opportunity for growth within the company. Lens Lab has been serving New York for over forty years and has a deep history of promoting from within which is exactly what we plan on doing for this role. Responsibilities • Assist processing insurance claims through both private insurance and Medicaid/Medicare, • Note and process all necessary forms from the insurance, • Assist patients in navigating the billing and insurance landscape, including collecting all necessary forms and signatures, • Work with doctors obtain charge information and billing details, • Enter all billing and payment information into the system properly and without errors, • Maintains the highest level of confidentialityDesired Qualifications, • Previous experience with medical coding and billing portals such as Versant, Eyemed, Trizetto, Availity, Eyesynergy and others, • Strong organization skills, • Excellent attention to detail

Job DescriptionBenefits: • 401(k), • Free uniforms, • Health insurance Benefits/Perks • Competitive Compensation, • Great Work Environment, • Career Advancement OpportunitiesJob Summary We are seeking a Medical Biller/ Front dek manager to join our outpatient cardiology clinic in uptown manhattan! As a Medical Biller, you will be working closely with patient, staff and the doctor to answer questions related to billing, processing all forms needed for insurance billing purposes, and collecting necessary documentation from clients. You will also assist other Medical Billers with follow-up inquiries to clients, communicate with physicians' offices and hospitals to obtain records, and accurately record patient information. The ideal candidate has excellent attention to detail, strong customer service skills, and is comfortable spending much of the day on the phone. Responsibilities • Assist with processing insurance claims through both private insurance and Medicaid/Medicare, • Note and process all necessary forms from the insurance, • Assist patients in navigating the billing and insurance landscape, including collecting all necessary forms and signatures, • Work with doctors offices and hospitals to obtain charge information and billing details, • Enter all billing and payment information into the system properly and without errors, • Follow up with clients and payments, as needed, • Answer phones, assist clients with questions, take messages, and screen calls, • Maintains the highest level of confidentialityQualifications, • Strong customer service skills, • Previous experience with medical coding or billing desired, • Strong organization skills, • Excellent attention to detail

Job Description Benefits/Perks • Competitive Compensation, • Great Work Environment, • Career Advancement OpportunitiesJob SummaryWe are seeking a Specialty Medical Biller to join our team! As a Medical Biller, you will be working closely with clients to answer questions related to billing, processing all forms needed for insurance billing purposes, and collecting necessary documentation from clients. You will also assist other Medical Billers with follow-up inquiries to clients, communicate with physicians' offices and hospitals to obtain records, and accurately record patient information. The ideal candidate has excellent attention to detail, strong customer service skills, and is comfortable spending much of the day on the phone. Responsibilities • Assist clients with processing insurance claims through both private insurance and Medicaid/Medicare, • Note and process all necessary forms from the insurance, • Assist patients in navigating the billing and insurance landscape, including collecting all necessary forms and signatures, • Work with doctor’s offices and hospitals to obtain charge information and billing details, • Enter all billing and payment information into the system properly and without errors, • Follow up with clients and payments, as needed, • Answer phones, assist clients with questions, take messages, and screen calls, • Maintains the highest level of confidentialityQualifications, • Strong customer service skills, • Previous experience with medical coding or billing desired, • Strong organization skills, • Excellent attention to detail, • Infusion Buy and Bill Medication coding necessary

Job Description Benefits/Perks • Competitive Compensation, • Great Work Environment, • Career Advancement OpportunitiesJob SummaryWe are seeking a Medical Biller to join our team! As a Medical Biller, you will be working closely with clients to answer questions related to billing, processing all forms needed for insurance billing purposes, and collecting necessary documentation from clients. You will also assist other Medical Billers with follow-up inquiries to clients, communicate with physicians' offices and hospitals to obtain records, and accurately record patient information. The ideal candidate has excellent attention to detail, strong customer service skills, and is comfortable spending much of the day on the phone. Responsibilities • Assist clients with processing insurance claims through both private insurance and Medicaid/Medicare, • Note and process all necessary forms from the insurance, • Assist patients in navigating the billing and insurance landscape, including collecting all necessary forms and signatures, • Work with doctor’s offices and hospitals to obtain charge information and billing details, • Enter all billing and payment information into the system properly and without errors, • Follow up with clients and payments, as needed, • Answer phones, assist clients with questions, take messages, and screen calls, • Maintains the highest level of confidentialityQualifications, • Strong customer service skills, • Previous experience with medical coding or billing desired, • Strong organization skills, • Excellent attention to detail

Job DescriptionBenefits: • Company parties, • Competitive salary, • Employee discounts, • Flexible schedule Benefits/Perks • Competitive Compensation, • Great Work Environment, • Career Advancement OpportunitiesJob Summary We are seeking a Medical Biller with experience in Optometry field to join our team! As a Medical Biller, you will be working processing all forms needed for insurance billing purposes, and collecting necessary documentation. The ideal candidate has excellent attention to detail, strong customer service skills, and is comfortable spending much of the day on the phone. Responsibilities • Assist processing insurance claims through both private insurance and Medicaid/Medicare, • Note and process all necessary forms from the insurance, • Assist patients in navigating the billing and insurance landscape, including collecting all necessary forms and signatures, • Work with doctors obtain charge information and billing details, • Enter all billing and payment information into the system properly and without errors, • Maintains the highest level of confidentialityQualifications, • Previous experience with medical coding and billing portals such as Versant, Eyemed, Trizetto, Availity, Eyesynergy and others, • Strong organization skills, • Excellent attention to detail

Job Description We are seeking an experienced, detail-oriented, and motivated Medical Biller with leadership experience to join our growing behavioral health organization. The ideal candidate is a team player with strong knowledge of mental health billing, revenue cycle management, Medicaid/Medicare, and commercial insurance claims. Responsibilities include overseeing billing operations, claim submission and follow-up, denial management, ensuring billing accuracy and compliance, and supporting team workflow and operational efficiency. Candidates should possess excellent organizational, communication, and problem-solving skills, with the ability to thrive in a fast-paced, collaborative environment. Experience within mental health or behavioral health billing is strongly preferred. Requirements • Minimum of 1 - 3 years of medical billing experience, preferably within mental health, behavioral health, psychiatry, or healthcare, • Leadership or supervisory experience strongly preferred, • Strong understanding of:, • Medicaid, • Medicare, • Commercial insurance billing, • Behavioral health CPT coding and claims processes, • Experience with EMR/EHR and billing software systems, • Excellent organizational skills and attention to detail, • Strong analytical, problem-solving, and follow-through abilities, • Ability to prioritize tasks and manage multiple responsibilities effectively, • Team-oriented mindset with strong interpersonal and communication skills, • Self-motivated, dependable, and proactive, • Manage and oversee daily behavioral health billing operations, • Submit and follow up on claims for mental health and psychiatric services, • Review claims for accuracy, completeness, and compliance prior to submission, • Monitor accounts receivable, denials, rejections, and unpaid claims, • Work collaboratively with providers, credentialing, and administrative departments, • Identify billing trends, workflow inefficiencies, and opportunities for process improvement, • Assist in supervising and supporting billing staff and team workflows, • Ensure compliance with payer guidelines, Medicaid/Medicare regulations, and behavioral health billing standards, • Maintain accurate documentation and reporting within EMR and billing systems, • Communicate professionally and effectively with insurance carriers and internal teams, • Support operational growth initiatives and revenue cycle optimization Benefits • Competitive compensation, • Supportive and collaborative team environment, • Opportunities for professional growth and leadership development, • Positive workplace culture focused on teamwork and communication, • Flexible and growth-oriented atmosphere, • Meaningful work within the behavioral health field, • Paid time off and holidays, • Health benefits, • Ongoing operational and team support We believe that workplace atmosphere, energy, and support play a vital role in both team success and quality patient care.

Job DescriptionBenefits: • Bonus based on performance, • Competitive salary, • Paid time off, • Training & development Benefits/Perks • Competitive Compensation, • Great Work Environment, • Career Advancement OpportunitiesJob Summary We are seeking a Chinese speaking Medical Biller to join our team! As a Medical Biller, you will be working closely with patients to answer questions related to billing, processing all forms needed for insurance billing purposes, and collecting necessary documentation from patients. You will also assist and follow-up inquiries to patients, communicate with physicians' offices and hospitals to obtain records, and accurately record patient information. The ideal candidate has excellent attention to detail, strong customer service skills, and is comfortable spending much of the day on the phone. Responsibilities • Assist clients with processing insurance claims through both private insurance and Medicaid/Medicare, • Note and process all necessary forms from the insurance, • Assist patients in navigating the billing and insurance landscape, including collecting all necessary forms and signatures, • Work with doctors offices and hospitals to obtain charge information and billing details, • Enter all billing and payment information into the system properly and without errors, • Follow up with patients and payments, as needed, • Answer phones, assist patients with questions, take messages, and screen calls, • Maintains the highest level of confidentialityQualifications, • Strong customer service skills, • Must speaking Chinese and English, • Previous experience with medical coding or billing desired, • Previous EMR system, EPIC or MDland prefered, • Strong organization skills, • Excellent attention to detail

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. Medical Biller Position Summary Reporting to the Revenue Cycle Manager, the Medical Biller will be responsible for the accurate and timely posting of insurance and patient payments, reconciliation of remittances, and aggressive follow-up of outstanding insurance balances. The ideal candidate will possess extensive experience with Explanation of Benefits (EOB) and Electronic Remittance Advice (ERA) posting, insurance denial management, and payer-specific reimbursement methodologies. This position requires a strong working knowledge of UnitedHealthcare, Aetna, Horizon Blue Cross Blue Shield, Medicare, and other commercial payers, with demonstrated success in filing reconsiderations, appeals, and overturning claim denials. Prior experience in a surgical practice environment is required, with vascular surgery experience strongly preferred. Essential Responsibilities Insurance Payment Posting & Reconciliation • Accurately post insurance and patient payments from EOBs, ERAs, EFTs, lockbox files, credit cards, cash, and paper checks., • Review and reconcile remittance advice to ensure payments, adjustments, contractual allowances, deductibles, coinsurance, and patient responsibilities are correctly applied., • Identify and research underpayments, overpayments, payment variances, and reimbursement discrepancies., • Balance daily payment posting batches and ensure all deposits reconcile to bank deposits and practice management system records., • Maintain complete and accurate documentation of all payment transactions and supporting remittance records. Insurance Accounts Receivable Management • Manage assigned insurance A/R work queues to ensure timely follow-up and resolution of outstanding claims., • Analyze unpaid, partially paid, and denied claims to determine root cause and appropriate corrective action., • Conduct payer follow-up via payer portals, telephone, and written correspondence., • Monitor aging reports and prioritize accounts to maximize collections and reduce days in A/R., • Escalate complex reimbursement issues and payer trends to Billing Management. Denials, Reconsiderations & Appeals • Review denial codes, payer policies, medical necessity determinations, bundling edits, authorization issues, and coding-related denials., • Prepare and submit reconsiderations, corrected claims, and formal appeals with supporting documentation., • Demonstrate strong knowledge of UnitedHealthcare, Aetna, Horizon BCBS, Medicare, and other commercial payer reimbursement policies and appeal processes., • Work collaboratively with providers, coding staff, and management to obtain documentation necessary to support successful appeal outcomes., • Track appeal status and ensure timely follow-up through final resolution. Surgical Billing Support • Understand surgical billing concepts including global surgical periods, modifiers, operative reports, authorizations, and payer-specific reimbursement guidelines., • Review surgical claims for completeness and identify issues impacting reimbursement., • Collaborate with coding and billing teams to ensure accurate claim submission and payment resolution., • Support vascular laboratory, vascular surgery, and related specialty billing functions as needed. Additional Responsibilities • Maintain accurate electronic records and documentation within the practice management system., • Respond professionally to inquiries from patients, providers, staff, and insurance representatives regarding billing and payment matters., • Assist with special projects, reporting, and revenue cycle initiatives as assigned., • Support the overall financial performance and collection efforts of the practice. Required Qualifications • Minimum 5 years of medical billing experience with a primary focus on insurance accounts receivable and payment posting., • Minimum 3 years of surgical practice billing experience required; vascular surgery experience strongly preferred., • Extensive experience posting EOBs, ERAs, EFTs, and manual payments., • Proven success resolving insurance denials, underpayments, and aging accounts receivable., • Strong working knowledge of UnitedHealthcare, Aetna, Horizon BCBS, Medicare, and commercial payer reimbursement methodologies., • Experience preparing and submitting reconsiderations, corrected claims, and formal appeals., • Thorough understanding of medical terminology, insurance billing practices, CPT, ICD-10, modifiers, and claim adjudication processes., • Proficiency with electronic health record (EHR) and practice management systems., • Strong analytical, organizational, and problem-solving skills., • Exceptional attention to detail and commitment to accuracy., • Ability to prioritize multiple responsibilities and meet established deadlines., • Excellent written and verbal communication skills. Preferred Qualifications • Experience with vascular surgery, general surgery, or other surgical specialties., • Familiarity with payer portals and electronic claims management systems., • Knowledge of Medicare Local Coverage Determinations (LCDs), National Coverage Determinations (NCDs), and commercial payer medical policies., • Revenue cycle management and denial prevention experience. Education • High School Diploma or equivalent required., • Associate’s or Bachelor’s degree in Healthcare Administration, Business, or related field preferred., • Medical Billing or Coding certification is a plus.

Job Description Benefits/Perks • Competitive Compensation, • Great Work Environment, • Career Advancement OpportunitiesJob SummaryWe are seeking a Medical Biller to join our team! As a Medical Biller, you will be working closely with clients to answer questions related to billing, processing all forms needed for insurance billing purposes, and collecting necessary documentation from clients. You will also assist other Medical Billers with follow-up inquiries to clients, communicate with physicians' offices and hospitals to obtain records, and accurately record patient information. The ideal candidate has excellent attention to detail, strong customer service skills, and is comfortable spending much of the day on the phone. Responsibilities • Assist clients with processing insurance claims through both private insurance and Medicaid/Medicare, • Note and process all necessary forms from the insurance, • Assist patients in navigating the billing and insurance landscape, including collecting all necessary forms and signatures, • Work with doctor’s offices and hospitals to obtain charge information and billing details, • Enter all billing and payment information into the system properly and without errors, • Follow up with clients and payments, as needed, • Answer phones, assist clients with questions, take messages, and screen calls, • Maintains the highest level of confidentialityQualifications, • Strong customer service skills, • Previous experience with medical coding or billing desired, • Strong organization skills, • Excellent attention to detail

Job DescriptionBenefits: • 401(k), • Competitive salary, • Flexible schedule, • Free food & snacks, • Opportunity for advancement, • Paid time off, • Tuition assistance Benefits/Perks • Competitive Compensation, • Great Work Environment, • Career Advancement OpportunitiesJob Summary We are seeking a Medical Biller to join our team! As a Medical Biller, you will be working closely with clients to answer questions related to billing, processing all forms needed for insurance billing purposes, and collecting necessary documentation from clients. You will also assist other Medical Billers with follow-up inquiries to clients, communicate with physicians' offices and hospitals to obtain records, and accurately record patient information. The ideal candidate has excellent attention to detail, strong customer service skills, and is comfortable spending much of the day on the phone. Responsibilities • Assist clients with processing corporate claims through both private pay and Medicaid/Medicare, • Note and process all necessary forms from the insurance, • Assist patients in navigating the billing including collecting all necessary forms and signatures, • Work with doctors offices and hospitals to obtain charge information and billing details, • Enter all billing and payment information into the system properly and without errors, • Follow up with clients and payments, as needed, • Answer phones, assist clients with questions, take messages, and screen calls, • Maintains the highest level of confidentialityQualifications, • Strong customer service skills, • Previous experience with medical coding or billing desired, • Strong organization skills, • Excellent attention to detail

Job Description About Us At Alteva RCM, we're dedicated to helping healthcare providers thrive through expert revenue cycle management, strategic insight, and innovative solutions. We're always looking for passionate, driven professionals who want to make a meaningful impact, grow their careers, and be part of a collaborative team committed to excellence. We are currently seeking a skilled Medical Biller to join our Client Implementation team, ensuring a smooth onboarding process for new physician accounts. This is a full time, in-person role located in Queens, New York. Primary Responsibilities • Ensure that all onboarding intake information is obtained for new physician enrollment, contracting, and other related purposes, • Coordinate provider set up with Sharefile, Billing Software and Clearing House, • Complete ERA/EFT enrollments for new and existing providers, • Communicate via phone and email with physician and administrative office staff to ensure a successful account implementation, • Guide new clients through the onboarding process, and answer any questions that arise, • Manage the early stages of new provider accounts until assigned to an account manager Qualifications • 2 years of experience in Medical Billing, • Familiarity with various portals (Navinet, Optum, Availity, CAQH, Medicare), • Experience with EFT and ERA enrollment, • Excellent communication skills (written and verbal), • Ability to work both independently and collaboratively within a team environment, • Attention to detail and strong time management skills Benefits M&D Capital offers our employees a comprehensive benefits package, including health, dental, vision, employee assistance plan, paid family leave, short-term disability and life insurance. We also provide a 401(k) plan with employer match, flexible spending accounts, employee discount program and an employee referral program. Salary Range This position offers a salary of $55,000-$65,000 per year, commensurate with experience. Job Type: Full-time Experience: • Medical billing: 2 years (Preferred) Ability to Commute: • Richmond Hill, NY 11418 (Required) Pay Range$26—$31 USD Benefits Alteva RCM offers our employees a comprehensive benefits package, including health, dental, vision, employee assistance plan, paid family leave, short-term disability and life insurance. We also provide a 401(k) plan with employer match, flexible spending accounts, employee discount program and an employee referral program.

A healthcare billing company is seeking an experienced CAH Biller to support full-cycle billing for Critical Access Hospitals. The role requires strong expertise in Epic billing workflows and Medicare reimbursement.