Integrated Resources

Urgent Requirement - Certified Professional Coder Full-time Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow. We’ve stayed true to our focus of finding qualified and experienced professionals in our specialty areas. Our partner-employers know that they can rely on us to find the right match between their needs and the abilities of our top-tier candidates. By continually exceeding their expectations, we have built successful ongoing partnerships that help us stay true to our commitments of performance and integrity. Our team works hard to deliver a tailored approach for each and every client, critical in matching the right employers with the right...

A leading company in strategic workforce solutions is seeking a Certified Professional Coder in Ewing, NJ. The role entails reviewing and translating medical policies and legislative mandates into accurate coding using CPT-4, HCPC, and ICD-9/ICD-10 standards. The successful candidate will have a clinical background, coding certifications, and several years of experience in medical coding and health insurance claims processing. #J-18808-Ljbffr

· We are seeking a highly motivated, detail-oriented, and adaptable professional to join our team and perform retrospective payment reimbursement reviews. · The ideal candidate is a fast learner who can hit the ground running, thrives in a fast-paced, deadline-driven environment, and can effectively manage multiple priorities with accuracy and efficiency. · The successful candidate will possess strong analytical and critical thinking skills, enabling them to evaluate complex reimbursement scenarios, identify payment discrepancies, interpret payer denials, and make well-supported payment determinations. · This individual must have a strong understanding of how modifiers impact reimbursement and how CPT codes interact with one another. · The candidate should be proficient in reading and interpreting Explanations of Benefits (EOBs), including recoupments, corrections, and other claim adjustments. · A broad and in-depth knowledge of CPT codes across all provider specialties is essential.

· We are seeking a highly motivated, detail-oriented, and adaptable professional to join our team and perform retrospective payment reimbursement reviews. · The ideal candidate is a fast learner who can hit the ground running, thrives in a fast-paced, deadline-driven environment, and can effectively manage multiple priorities with accuracy and efficiency. · The successful candidate will possess strong analytical and critical thinking skills, enabling them to evaluate complex reimbursement scenarios, identify payment discrepancies, interpret payer denials, and make well-supported payment determinations. · This individual must have a strong understanding of how modifiers impact reimbursement and how CPT codes interact with one another. · The candidate should be proficient in reading and interpreting Explanations of Benefits (EOBs), including recoupments, corrections, and other claim adjustments. · A broad and in-depth knowledge of CPT codes across all provider specialties is essential.

Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow. We’ve stayed true to our focus of finding qualified and experienced professionals in our specialty areas. Our partner-employers know that they can rely on us to find the right match between their needs and the abilities of our top-tier candidates. By continually exceeding their expectations, we have built successful ongoing partnerships that help us stay true to our commitments of performance and integrity. Our team works hard to deliver a tailored approach for each and every client, critical in matching the right employers with the right candidates. We forge partnerships that are meant for the...

Job Title: HCC | Risk Adjustment Coder Location: Newark, NJ (100% Remote) Duration: 6 months (possible extension) Pay Rate: $30 - $35/hr. on W2 Schedule: Regular Business Hours. Important Details: Candidates can be located in any one of the five states: NJ, NY, PA, CT, and DE You will be required to travel for the pickup and return of equipment, and/or laptops that need servicing. Job Summary: Responsible for reviewing, auditing, coding, and analyzing medical records to ensure accurate diagnosis documentation and HCC abstraction. Supports Medicare, Medicaid, Commercial Risk Adjustment programs, and RADV audits while ensuring compliance with ICD-10 coding guidelines and risk adjustment regulations. Key Responsibilities Review medical records for coding accuracy, completeness, and compliance Abstract and validate HCC diagnoses using ICD-10, CPT, and HCPCS coding systems Support Medicare Advantage, Medicaid, Commercial, and ACA risk...

Title: Associate Director, Medical Affairs Location: Cambridge, MA (100% Remote) Duration: 6 Months+ Possible Extension Pay Range: $100-$120/hr Manager Notes: Hybrid preferred. But remote candidates can also be considered. If Hybrid, expected to visit the office at least twice a week. No specific days, depends upon the requirement. High likelihood of further extensions beyond the given end date. Summary & Purpose of the Position Reporting to the Senior Director, Medical Affairs (Adult Cholestatic Diseases), the Associate Director, Medical Affairs, will support and oversee select medical affairs activities related to biliary atresia. This role will contribute to the U.S. medical strategy for elafibranor and the broader Medical Affairs plan for cholestatic diseases . Responsibilities include medical review of non-promotional and promotional content, information responses (in collaboration with Medical Information), scientific communications...

Job Title: Certified Professional Coder Job Location: Hopewell, NJ Job Duration: 6 Months (possibility of extension) Payrate: $35 - $38/ hr. on w2 Job Summary: This position is responsible for leading on-site and desk audits of hospital billing and coding practices, including forms development, audit profiling, and tracking institutional audit trends. The role involves designing audit protocols, handling special projects, and performing/finalizing per diem audits, bill verification, DRG validation (utilization review audits), and credit balance reviews. The position also provides education and guidance on ICD-10-CM coding, DRG assignment, payment methodologies, and auditing practices. Key Responsibilities: Lead hospital billing and coding audits, both on-site and remote Identify and present billing discrepancies and coordinate improper claim payment referrals Analyze trends related to documentation, billing errors, and provider contract interpretation issues...

Fully Remote role - Must reside in CA - CPC, CCS, or equivalent certification required. Specialty coding certification is highly desired. **ROLE REQUIREMENTS** Surgical breast oncology (including plastic reconstructive breast surgery), Hematology/Oncology Must be able to abstract the chart review to capture all billable charges EPIC experience: charge entry and charge review experience required Strong Evaluation and Management (E/M) inpatient and outpatient coding experience Must reside in CA but can be remote Profee ONLY - NOT HCC/risk adjustment, ASC, or facility coding Desire to convert to full-time employment **Bonus/nice to have** Bonus: GYNONC coding experience Bonus: Experience working on denials Bonus: GI (CGIC coding certification) or OBGYN (COBGC coding certification) coding experience (1 year or more) Job Description: Under the direction of the Coding Compliance Manager, the Specialty Physician Coder plays a key role in...