- Humana (Harrisburg, PA)
- …with an external provider. Some roles include an overview of coding practices and clinical documentation, dispute/grievance and appeals processes, and outpatient ... Director. The Medical Director conducts post-service, inpatient care reviews for accurate billing of clinically valid diagnoses and care received. May also engage in… more
- CVS Health (Harrisburg, PA)
- …related to clinical findings + Initiates proactive data mining to identify aberrant billing patterns + Makes referrals, both internal and external, in the required ... the area of healthcare fraud and abuse matters. + Working knowledge of medical coding ; CPT, HCPCS, ICD10 + Proficiency in Microsoft Office with advanced skills in… more
- CSL Behring (King Of Prussia, PA)
- …significant activities, progress and follow-up needed. + Assess reimbursement environment (coverage, coding and payment) for any new products and procedures. + Work ... visits, presentations to healthcare providers and other medical staff. Conduct billing procedure review for home care companies, pharmacies, and other providers… more
- Deloitte (Pittsburgh, PA)
- …one or more of the following revenue cycle functions: Patient Access, Coding , Revenue Integrity, HIM, Charge Integrity, Patient Financial Services. + Proficiency and ... experience with financial, billing , and reimbursement data. + Working knowledge of the UB-04, MA claim form, HCFA-1500, claim form and claim scrubber. + Experience… more
- Cardinal Health (Harrisburg, PA)
- …drive business value. Application Development & Maintenance performs configuration or coding to develop, enhance and sustain the organization's software systems in ... the areas of the SAP Finance domain + Prior work experience in SAP Billing and Revenue Innovation Management (BRIM) is a plus + Excellent organizational skills… more
- Oracle (Harrisburg, PA)
- …teams. + 3+ years of experience as a medical scribe, clinical documentation, medical billing or auditing, with a focus on analyzing and optimizing healthcare data. + ... degrees or partial medical training a plus. + Familiarity of Healthcare coding systems (SnomedCT, ICD 9/10/11) and Health care compliance standards (eg HIPAA).… more
- Highmark Health (Harrisburg, PA)
- …member satisfaction. Will be expected to identify potential discrepancies in provider billing practices and intervene for resolution and education or if necessary ... and regulatory compliance. Implements all reviews according to accepted and established coding criteria, as well as other approved guidelines, payment and medical… more
- Norstella (Harrisburg, PA)
- …insights from **real-world data (RWD)** sources, including **claims, laboratory results, billing codes, and electronic health records (EHRs)** . You will be ... data, in an academic or industry setting. + Experience working with healthcare coding systems (CPT, NDC, ICD-10) and drug/medication data. + Strong understanding of… more