- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims data and coding of ... CPT, are assigned to support the services/treatment rendered. The Coding Appeals Specialist also prepares appeal arguments and/or letters to support and defend the… more
- UPMC (Pittsburgh, PA)
- …and DRG assignment appropriateness to ensure consistency and efficiency in claims processing, data collection, and quality reporting. + **Post-Audit ... they meet state and federal regulations. **Key Responsibilities:** + **Comprehensive Auditing :** Conduct UPMC-wide auditing and monitoring to ensure that… more
- Highmark Health (Harrisburg, PA)
- …analytical and communication skills Preferred + Associate's Degree + 3 years with claims processing and data management + Past auditing and strong ... and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs,… more
- UPMC (Pittsburgh, PA)
- …ICD-10-CM, CPT, and HCPCS codes to ensure consistency and efficiency in claims processing, data collection, and quality reporting. . **Regulatory Compliance:** ... the potential to work from home. **Key Responsibilities:** . **Comprehensive Auditing :** Conduct UPMC-wide audits to ensure medical record documentation supports the… more