• Auditor, HCC Risk Adjustment Coding - Full…

    Datavant (Harrisburg, PA)
    …and reimbursement purposes. You will play a critical role in translating clinical documentation into precise codes that reflect the complexity and severity of ... to the table:** + Minimum 3 years of HCC coding experience + Minimum 2 years of HCC Auditing...CPC-H, COC, CIC or CRC). + Proficient in ICD-10 coding . + Experienced in HCC coding across… more
    Datavant (08/08/25)
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  • Physician-based Oncology Senior Complex Coder

    Banner Health (PA)
    …area of specialty. Requires five or more years of specialized, complex professional coding experience for clinical specialty areas. Must demonstrate an elevated ... **Department Name:** Coding Ambulatory **Work Shift:** Day **Job Category:** Revenue...practices by evaluating medical records and validating that appropriate clinical diagnosis and procedure codes are assigned in accordance… more
    Banner Health (09/05/25)
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  • Charge Entry & Edit Specialist - Corporate…

    Guthrie (Sayre, PA)
    …Medical office experience and knowledge of medical terminology preferred. Basic coding knowledge of CPT, ICD‐10, and modifier application is necessary. Demonstrate ... Gastroenterology and Pulmonary Critical Care Fellowship programs. Guthrie is also a clinical campus for the Geisinger Commonwealth School of Medicine. more
    Guthrie (08/13/25)
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  • Medicaid Insurance Product Manager

    Humana (Harrisburg, PA)
    …**Preferred Qualifications** + Advanced degree (MPH, MBA, or similar). + Experience in clinical operations or medical coding . + Strong financial acumen. + ... insights to inform product strategy. + Collaborate cross-functionally with clinical , financial, actuarial, and operational teams to develop value-added benefits… more
    Humana (09/27/25)
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  • Dir-Reg and Compl Stratgy

    Genesis Healthcare (Kennett Square, PA)
    …Assists in the development and maintenance of compliance resources (eg, coding tools, clinical programs, operational initiatives). Utilizes a project ... to Full-Time and Part-Time team members.** + **Support for New Grads: Our Powerback Clinical Mentorship Program kicks off on day one, helping you learn from the best… more
    Genesis Healthcare (09/30/25)
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  • RN/ Clinical Documentation Specialist

    St. Luke's University Health Network (Allentown, PA)
    …serve, regardless of a patient's ability to pay for health care. The Clinical Documentation Specialist is responsible for the review of inpatient medical records to ... and nursing staff. Active participation in team meetings and education of the clinical staff in clinical documentation improvement are key functions of the… more
    St. Luke's University Health Network (09/17/25)
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  • Medical Director-Payment Integrity

    Humana (Harrisburg, PA)
    …discussions with an external provider. Some roles include an overview of coding practices and clinical documentation, dispute/grievance and appeals processes, ... and work is assisted by diverse resources, which may include national clinical guidelines, CMS policies and determinations, clinical reference materials,… more
    Humana (09/26/25)
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  • Medical Director - Claims Management

    Humana (Harrisburg, PA)
    …may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, dispute, grievance, and appeals processes, ... and work is assisted by diverse resources, which may include national clinical guidelines, CMS and state policies and determinations, clinical reference… more
    Humana (09/17/25)
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  • Medical Director - Southeast Region

    Humana (Harrisburg, PA)
    …these may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and ... and work is assisted by diverse resources, which may include national clinical guidelines, CMS policies and determinations, clinical reference materials,… more
    Humana (09/10/25)
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  • Dialysis Clinical Manager Registered Nurse…

    Fresenius Medical Center (Dallas, PA)
    …requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory ... and FMS patient care and administrative policies as the clinical leader, has the authority to make daily decisions...completion of the Annual Standing Order Review and ICD coding . + Checks correspondence whether electronic, paper or voice… more
    Fresenius Medical Center (09/13/25)
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