Jobtailor

Submit and follow up on government and commercial payer claims to secure appropriate reimbursement Prevent denials by validating authorization, eligibility, medical necessity indicators, modifiers, diagnosis/procedure alignment, and required documentation Review claim edits and resolve preventable edits to maximize first-pass acceptance Monitor denial and rejection patterns by payer, plan, and category Conduct root cause analysis and implement prevention actions with Denials Analysts and Leadership Maintain payer requirement grids, reference files, tip sheets, and other denial prevention tools Communicate payer policy changes, recurring denial themes, and emerging risks Bill primary, secondary, and tertiary payers and initiate patient balance billing according to policy and regulations Monitor assigned insurance work queues and resolve encounters, including Charge Error DOS, Adjustments, and Client Bill workqueues Investigate and resolve payer rejections, denials, and...

Jobtailor in Glen Rock, NJ is seeking an experienced Medical Billing Specialist to manage billing and collections, review claims, and coordinate with clinics, patients, and insurers. The role emphasizes accuracy, documentation, and timely issue resolution. You will work with billing software, HRM systems, and coordinate with staff to ensure compliant processes and milestones are met. Strong Excel and communication skills are essential. #J-18808-Ljbffr

Jobtailor in Ohio is seeking a Medical Billing Specialist with ICD-9 and CPT coding knowledge to support a multi-specialty practice. You will monitor unresolved accounts, initiate follow-up, communicate with payors, and help resolve billing discrepancies while safeguarding patient information. The ideal candidate holds CPC, CCS, RHIT, or RHIA credentials, has 1+ year of medical billing experience, excellent verbal and written communication, and meticulous attention to detail. #J-18808-Ljbffr

Jobtailor is seeking a Medical Billing & Coding Specialist to code encounters using ICD-10 and CPT guidelines and to prepare, submit, and monitor claims with various payers. You will work with providers and staff to resolve issues and ensure timely payments. The role requires attention to detail, strong organizational skills, and clear communication. Occasional travel to Montana/Wyoming sites may be needed for technical issues or management purposes. #J-18808-Ljbffr

Track, prioritize and manage execution of observational studies across all therapeutic-area portfolios Collaborate on strategic sourcing options to optimize portfolio execution Manage vendor performance, issues and escalation of portfolio risks Maintain vendor oversight plans and perform quality checks of study deliverables Support initiation and execution of study vendor and service provider agreements Align study objectives and timelines with scientific leads, stakeholders and vendors Oversee study deliverables end to end and ensure timely, high-quality completion Track study milestones, timelines, deliverables and financials; identify and mitigate risks Monitor resource utilization and assignment against portfolio priorities Ensure onboarding of study vendors and service-provider resources Monitor compliance with process requirements, regulatory guidelines and study objectives Resolve quality, scope and timeliness issues with operational stakeholders Maintain communication with...

Review new patient records in billing software and initiate billing process Work with clinic staff to resolve patient authorization issues Review existing claims in billing software and follow up on outstanding issues Review outdated claims in billing software to research and resolve as necessary Review outdated claims in billing software and prepare for collection as necessary Work with insurance companies to resolve billing issues Work with patients to resolve billing and collection issues Ensure all billing changes, charge offs, escalations, interactions etc. are correctly documented in billing and/or HRM software in a timely manner Properly elevate billing issues where necessary Follow company processes and procedures carefully Prepare and update summary documentation as required Other duties as assigned by management Requirements Minimum 3 years’ experience with medical billing required (1 year with 2-year college degree or greater) Solid understanding of medical billing...

Jobtailor in Lakeland, FL is seeking a Medical Billing Specialist to review and process workers' compensation claims, ensuring accuracy and regulatory compliance. You will cross-reference claim details, resolve billing discrepancies with providers and claimants, and support inquiries while maintaining HIPAA standards. This full-time role collaborates with claims reps and internal teams to maintain precise records and generate periodic reports. #J-18808-Ljbffr

Jobtailor in Madison, WI, seeks a Medical Coding Supervisor to coach coding staff, lead HCC coding initiatives, and collaborate with Clinical Documentation Improvement. The role includes hiring, onboarding, training, and coordinating staffing; hybrid work from home with periodic onsite meetings in Madison. The ideal candidate has CPC or equivalent certification, leadership experience in medical coding, and a strong track record of maintaining quality and production standards within healthcare #J-18808-Ljbffr

Conduct comprehensive medical record reviews to ensure billing is consistent with medical records Provide detailed written summaries of medical record review findings Articulate findings to investigators, Medicaid plan leadership, law enforcement, legal counsel, providers and state regulators Review and discuss cases with Medical Directors to validate decisions Assist with investigative research related to coding questions, state and federal policies Identify potential billing errors, abuse and fraud Identify opportunities for savings related to potential prepayment review cases Maintain appropriate records, files and documentation Travel for meetings and potentially testify Requirements AAPC Coding certification — Certified Professional Coder (CPC) 3+ years of experience in medical coding or documentation auditing Strong knowledge of CPT, HCPCS, Revenue Codes, CMS 1500 and UB04 data elements Experience researching coding, state regulations and policies Working experience with...

Jobtailor is seeking an experienced Medical Coding Auditor to conduct comprehensive medical record reviews and ensure billing accuracy. You will craft detailed written summaries and present findings to investigators, leadership, counsel, providers, and regulators. Role requires reviewing cases with Medical Directors, researching coding policies, and potentially testifying. Travel for meetings is expected, and strong Excel skills are essential. #J-18808-Ljbffr

Prepare and process various insurance claims Verify data by conferring with appropriate agencies daily Create and process electronic claims submissions for various payers daily Research claim errors, make corrections, and resubmit claims Review AR reports daily and follow up on delinquent accounts Receive, investigate, and respond to payer and agency inquiries concerning AR activity Maintain and develop AR schedules to track issues and resolutions Resolve customer requests, inquiries, and concerns Requirements High school diploma required Medical billing/coding certification preferred Insurance verification or claims experience AR experience nice to have Critical thinker and independent worker Insurance verification Denials management Prior authorization Insurance claims and claims process Must be able to work onsite in Louisville initially Contract-to-hire position based out of Louisville, Kentucky Core Competencies Demonstrates expertise in processing insurance claims, verifying...

Jobtailor in Cleveland offers a Compliance/Audit role focused on property management, auditing, and regulatory reporting. You will prepare submissions to state agencies and syndicators, track deadlines, and conduct on-site audits across stabilized and lease-up properties. Proficiency with Yardi and a strong eye for compliance are essential for success. Ideal candidates have 2–5 years in property management, with market-rate and affordable housing experience, and hold or pursue HCCP/CP3 or #J-18808-Ljbffr

Audit and prepare files for submission to State agencies and Syndicators Track and schedule syndicator due dates for first-year file submissions Review Yardi uploads weekly and report file-upload progress to sites Conduct site visits to assist with uploads and process syndicator corrections Obtain and execute corrections required by state agencies, syndicators, auditors, and loan providers Submit weekly progress updates to the VP of Operations and Compliance and Director of Compliance Pull and review Bond TIC reporting and ensure Bond TICs are submitted by required deadlines Perform on-site audits for stabilized and lease-up sites Represent NRP during on-site audits with external agencies Complete site-audit reporting and ensure required corrections are completed Meet with Compliance staff to review findings and identify training needs Review supportive-service requirements and site plans, ensuring services begin at or before 40% occupancy Enter and review annual Owner...

Provide strategic project management support across Medical Affairs and cross-functionally Manage Company Sponsored Phase 4 study operations end to end, including CRO oversight and cross-functional alignment Operationalize Medical Affairs planning, including budget planning with Medical Directors Support congress planning, reports, and congress-specific training materials Maintain Medical Affairs SharePoint databases, budgets, medical resources, and departmental report repositories Create project timelines, monitor strategic project progress, and ensure deliverables are completed on time and within budget Support advisory boards, publications, and congress meetings Lead development of the monthly Medical Affairs dashboard Maintain calendars of program, congress, and internal meetings Plan, implement, and maintain departmental platforms Maintain quarterly business updates and support preparation for Executive Leadership Team and Senior Leadership Team presentations Author and...

Provide strategic and operational medical writing expertise to prepare high-quality complex clinical and regulatory documents for health authority submissions. Contribute to the medical and regulatory writing portfolio and collaborate across functional groups within the company. Lead and maintain standardized document development processes for clinical and regulatory documents. Develop and execute strategies for organizing and preparing documents for clinical and regulatory health authority submissions. Independently author and/or lead the authoring and end-to-end development of clinical and regulatory documents. Write, review, and edit science-based documents such as those included in IND/NDA sections. Provide high-quality medical writing support to documents led by other company functional groups. Manage contract medical writers, as needed, and review documents produced by external writers. Collaborate with relevant company subject matter experts and document owners to develop...