32 jobs found in Newark

Licking Memorial Health Systems in Newark, Ohio is seeking a qualified healthcare compliance auditor with a nursing background to ensure Medicare/Medicaid documentation and billing accuracy. Under the VP of Financial Services, you will audit home care, patient status, and billing processes to support state and federal requirements. This role emphasizes collaboration with physicians and staff, confidentiality, and error analysis, with no remote work. #J-18808-Ljbffr

Job Description Job Description Accounts Receivable / Medical Biller Newark, NY $21.00 per Hour Monday-Friday | 8:00 AM - 4:30 PM Contract-to-Hire Opportunity Are you an experienced Accounts Receivable professional with medical billing knowledge? We are seeking a detail-oriented and organized Accounts Receivable / Medical Biller to join a growing healthcare organization in Newark, NY. This full-time, contract-to-hire opportunity offers a stable weekday schedule, competitive pay, and the potential for long-term career growth. Key Responsibilities Process medical insurance claims and troubleshoot clearinghouse rejections Research and resolve denied or outstanding claims Accurately post patient and insurance charges Process and post payments in a timely manner Monitor and maintain accounts receivable balances Communicate with insurance carriers regarding claim discrepancies and billing issues Maintain billing reports, records, and tracking...

LMHS Compliance Auditor Licking Memorial Health Systems (LMHS) is a leading, non‑profit healthcare organization, passionately dedicated to improving the health and well‑being of our community. With a history dating back to 1898, LMHS remains a cornerstone of healthcare excellence, catering to the evolving needs of Licking County. Our cutting‑edge facility provides a comprehensive spectrum of patient care services, from life‑saving emergency medicine to the comforting embrace of home healthcare, with a unique range of specialized medical services, including cancer, heart health, maternity, and mental wellness. When you join the LMHS team, you become a vital part of your local community hospital. Working at LMHS is not just a job, it is a unique opportunity to directly impact the health and well‑being of your friends, family, and neighbors, and the impact of your work extends beyond the hospital doors into the heart of our community. Position Description Under the general direction...

CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $57,400 to $99,000 annually based on experience The Physician Coding Auditor develops and implements strategic needs analyses and training plans for coding leadership; coordinates and evaluates curriculum development and conducts the preparation and delivery of training for Medical Coders employed by Ensemble and providers that are contracted/employed and outlined in the client SOW. Provides guidance and leadership to coding and billing management in the implementation and administration of effective systems, processes, and procedures. Performs annual performance reviews and quality assurance reviews to assess comprehension of training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting...

CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $57,400 to $99,000 annually based on experience The Coder Quality Auditor conducts monthly and quarterly quality assessments of individual codes. Provides guidance and education to coding associates and leaders on established coding guidelines and procedures. Performs additional quality assurance follow-up reviews to assess comprehension of education and training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting professional coding standards and following CMS/AMA guidelines.  Candidate should possess the ability to code and a clear understanding of the coding principles and guidelines for multiple specialties.  Job Responsibilities: Quality Review - Monitors and audits inpatient and outpatient...

Licking Memorial Health Systems is seeking a Compliance Auditor responsible for auditing and monitoring adherence to state and federal documentation and billing requirements across LMHS. This position reports to the VP of Financial Services and emphasizes collaboration with clinicians and administrators to improve processes. The role focuses on home care, patient-level care, and internal audits, ensuring compliance with CMS, OIG, ODH, ODM, and RAC standards. #J-18808-Ljbffr

Job Details: Newark, NJ 07105; Full Time; Salary Range: $28.00 - $28.00 Hourly; Shift: Day. Position Summary Responsible for the oversight of the unit’s medical records. Provides leadership to Medical Records Clerks, management of EHR system and/or physical charts, files documents and medical releases, and conducts chart maintenance. Qualifications Associate’s degree 2‑3 years’ experience in healthcare and working with electronic medical records Must update and maintain skills and knowledge related to correctional health Performance Expectations Provides leadership to medical records staff Main point of contact for medical record department Acts as project manager for medical records process Provides necessary medical records for members of the healthcare team Reviews medical records for accuracy and completeness Ensures that all required documents and releases are included in all patient charts Maintains admission and discharge records Processes release of information requests...

Position Summary Responsible for the oversight of the unit’s medical records. Provides leadership to Medical Records Clerks, management of EHR system and or physical charts, files documents and medical releases, and conducts chart maintenance. Qualifications Position Requirements An associate’s degree 2-3 years’ experience in healthcare and working with electronic medical records Must update and maintain skills and knowledge related to correctional health. Performance Expectations Provides leadership to medical records staff Main point of contact for medical record department. Acts as project manager for medical records process Provides necessary medical records for members of the healthcare team Reviews medical records for accuracy and completeness Ensures that all required documents and releases are included in all patient charts Maintains admission and discharge records Processes release of information requests Prepares routine correspondence Assists in providing...

Medical Billing Specialist (Revenue Cycle Management) – Bilingual Spanish Preferred This is not a Remote position; it is in the Office Monday - Friday. This is not an entry-level role and requires independent ownership of revenue cycle processes. Position Summary Reliant Healthcare Group is seeking an experienced Medical Billing Specialist with demonstrated Revenue Cycle Management (RCM) expertise. This role is responsible for managing AR, payer follow-ups, and claim resolution to ensure timely reimbursement. Essential Duties & Responsibilities Manage full Revenue Cycle Management (RCM) processes Verify insurance eligibility and benefits for commercial and Medicaid MCO payers Follow up on Accounts Receivable exceeding 30 days Review AR aging reports and resolve outstanding balances Post payments and perform account reconciliations Obtain and manage insurance authorizations Review and correct claims to prevent denials Interpret payer contracts and reimbursement...

This is a remote based position. Applicants can be located nationwide Back Outpatient Coding Auditor #2814 United States Apply X Facebook LinkedIn Email Copy Position Description About You You are a person who is passionate about performing quality reviews and audits of the assigned staff. We need someone who ensures standards are met in accordance with department and organization policy. In the role of Outpatient Coding Auditor, you will demonstrate skills in organization, prioritization, professionalism and coaching others. Tell us about your experience with Outpatient Coding Auditing. Are you a team player and a self-motivator? We are counting on you to manage multiple projects using your problem-solving skills. We are looking for someone UNCOMMON. What is uncommon about you? Are you highly committed? Are you team-oriented? Do you value professionalism, trust, honesty, and integrity? If so, we cannot wait to meet you. About The Position Advanced...

Senior Risk Adjustment Coder The Senior Risk Adjustment Coder will perform code audits and abstraction in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The HCC Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs: including but not limited to Medicare Advantage Risk Adjustment. What you will do: Risk Adjustment Review May perform prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditing Reviewing medical records to ensure accurate HCC coding and identify opportunities for recapture and suspect diagnoses. Evaluating medical records to verify that M.E.A.T criteria support the submitted diagnosis codes. Inquire with clinicians the recommended HCC diagnosis for chart addendum. Collaborating with other departments to address coding updates and support risk...

Medical Coding & Risk Adjustment Auditor (Remote Contract) Location: Remote Duration: 6+ Month Contract Client: New Jersey-Based Healthcare Organization Position Summary We are seeking an experienced Medical Coding & Risk Adjustment Auditor to support a healthcare client's Risk Adjustment and Data Validation initiatives. This role is responsible for reviewing, interpreting, auditing, coding, and analyzing medical record documentation to ensure diagnosis accuracy, proper documentation, and Hierarchical Condition Category (HCC) abstraction. The position supports Annual Commercial (ACA) and Medicare Advantage Risk Adjustment Data Validation (RADV) audits, as well as ongoing Risk Adjustment activities across Medicare, Medicaid, and Commercial lines of business. Key Responsibilities Review, interpret, and translate CPT, HCPCS, ICD-9, and ICD-10 codes for HCC abstraction. Audit medical records for completeness, accuracy, and compliance with applicable...

Job Details Do you want to work at one of the Top 100 Hospitals in the nation? We are guided by our values of Love and Excellence and are passionate about delivering health, not just health care. Come join us at ChristianaCare! ChristianaCare, with Hospitals in Wilmington and Newark, DE, as well as Elkton, MD, is one of the largest health care providers in the Mid-Atlantic Region. Named one of "America's Best Hospitals" by U.S. News & World Report, we have an excess of 1,100 beds between our hospitals and are committed to providing the best patient care in the region. We are proud to that Christiana Hospital, Wilmington Hospital, our Ambulatory Services, and HomeHealth have all received ANCC Magnet Recognition. Scheduling Flexibility and Perks The schedule and hours for this position are very flexible and we will work with you on work/life balance to build a schedule that works for you This position is 100% remote and we encourage national candidates to apply We...

Licking Memorial Health Systems in Newark, OH seeks a compliance auditing professional under the VP of Financial Services to ensure documentation and billing meet state and federal requirements. This role focuses on home care and patient status audits, coordinates with CMS, OIG, ODH, ODM and RAC, and communicates findings to leadership. Join a mission-driven team dedicated to patient safety and regulatory excellence while maintaining confidentiality and integrity. #J-18808-Ljbffr

Provider Liaison - Certified Professional Coder (CPC) / Certified Coding Specialist (CCS) A Few Words About Us Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing. Job Description One of our direct client is looking for potential candidate with the below mentioned skills Direct Client: Immediate Interview Contract to Hire Position: Provider Liaison MUST HAVE: 5 years of experience into Project Management At least 2 years of experience after CPC or CCS certification Bachelor's degree is a must Certifications AAPC Certified Professional Coder (CPC) or...

Professional Coder I Our client, a Health Insurance company, is looking for a Professional Coder I for their Newark, NJ location. Responsibilities: This position is accountable for accurately reviewing, interpreting, auditing, coding and analyzing medical record documentation for diagnosis accuracy, correct documentation, and Hierarchical Coding Condition (HCC) abstraction. Review may include inpatient, outpatient treatment and/or professional medical services, according to ICD-9/ICD-10 CM coding guidelines and risk adjustment model regulations. This position supports Annual Commercial (ACA) and Medicare Advantage Risk Adjustment Data Validation Audits (RADV) along with the annual Risk Adjustment life cycle for the Medicare, Medicaid, and Commercial lines of business. Can understand and translate CPT, HCPC, ICD-9/ICD-10 codes for HCC abstraction. Review medical records for completeness, accuracy and compliance with applicable coding guidelines and regulations....

Summary: This position is accountable for accurately reviewing, interpreting, auditing, coding, and analyzing medical record documentation for diagnosis accuracy, correct documentation, and Hierarchical Coding Condition (HCC) abstraction. Review may include inpatient, outpatient treatment, and/or professional medical services, according to ICD-9/ICD-10 CM coding guidelines and risk adjustment model regulations. This position supports Annual Commercial (ACA) and Medicare Advantage Risk Adjustment Data Validation Audits (RADV) along with the annual Risk Adjustment life cycle for the Medicare, Medicaid, and Commercial lines of business. Responsibilities: Understand and translate CPT, HCPC, ICD-9/ICD-10 codes for HCC abstraction. Review medical records for completeness, accuracy, and compliance with applicable coding guidelines and regulations. Identify, compile, and code member/patient data using ICD-9/ICD 10-CM and other standard classification coding systems. Support the...

Signature Performance is seeking a Medical Coding Specialist passionate about accurate coding of diagnoses and procedures. You will review documentation and ensure compliance with coding guidelines and regulations, managing multiple projects efficiently. Offering a full-time position within a supportive culture, you will enjoy a range of benefits including health insurance, paid time off, and professional development opportunities. #J-18808-Ljbffr

If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered.Day - 08 Hour (United States of America)This is a Stanford Health Care - University Healthcare Alliance job.A Brief OverviewThe Senior Risk Adjustment Coder will perform code audits and abstraction in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The HCC Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs: including but not limited to Medicare Advantage Risk Adjustment.LocationsStanford Health Care - University Healthcare AllianceWhat you will doRisk Adjustment ReviewMay perform prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditingReviewing medical records to ensure accurate HCC coding and...

Certified Professional Coder (CPC) Lead/Provider Liaison A Few Words About Us Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing. This is Contract position with my direct client Job Description Direct Client Need- Immediate Interviews- We have a strong hold, with many consultants working onsite! Location could be: Newark, NJ OR West Trenton OR Ewing OR Wall, NJ Duration: Contract to Hire Job Summary: The Provider Liaison is accountable for extracting insights specific to providers and provider groups regarding commercial risk adjustment and developing educational...