- Cardinal Health (Harrisburg, PA)
- …and proactively provides guidance and trainings on policies. Reporting to the Director , Ethics & Compliance, this position supervises and manages audits to determine ... coders, billers and other appropriate staff. This position will also support the Director with transactional audit diligence and integration planning, as well as the… more
- Genesis Healthcare (Camp Hill, PA)
- …of the RN Nursing Supervisor, Unit Manager, ADON or ADON - Unit, or Director of Nursing (Nurse Leader), the Registered Nurse (RN) delivers efficient and effective ... within the Compliance and Ethics Program, Standard/Code of Conduct, Federal False Claims Act and HIPAA. 2. Participates in required orientation and training… more
- Highmark Health (Wexford, PA)
- …and prepares such cases for clinical review by a pharmacist and/or medical director when required. (20%) + Within the context of the request, applies plan-specific ... for all preauthorization entries into applicable databases (ie internal medical claims systems, PBM pharmacy systems) to ensure swift and appropriate payment… more
- St. Luke's University Health Network (Easton, PA)
- …practices. Communicate with insurance carriers to obtain payment for prescription claims ;. At point of sale, verify that customer receives correct prescription(s);. ... chemo spill kit. SUPERVISION (RECEIVED BY AND/OR GIVEN TO): Received: Director of Pharmacy, Staff Pharmacist COMMUNICATIONS: Communicates with co-workers, nurses,… more
- Evolent (Harrisburg, PA)
- …coding team and operations, ensuring accurate and timely ICD-10 coding of claims via progress note clinical documentation review. + Ensure compliance and quality ... regular coding questions and issues. + Collaborate with the coding director to develop policies, procedures, and workflows to enhance department efficiency.… more