- Datavant (Harrisburg, PA)
- …realize our bold vision for healthcare. The purpose of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of ... recognized medical necessity criteria and standards of care, along with clinical knowledge and expertise successfully. Ideal candidate should be a Licensed… more
- Penn Medicine (East Petersburg, PA)
- …Working for this leading academic medical center means collaboration with top clinical , technical and business professionals across all disciplines. Today at Penn ... are met in an appropriate manner. Responsibilities: + Analyzes and researches denials and follows-up with the appropriate payor, practice, and/or patient to resolve… more
- St. Luke's University Health Network (Allentown, PA)
- …regardless of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data ... DUTIES AND RESPONSIBILITIES: + Conduct retrospective medical record reviews for clinical validation of diagnosis and procedure code assignment and MS-DRG/APR-DRG… more
- Penn Medicine (Philadelphia, PA)
- …Working for this leading academic medical center means collaboration with top clinical , technical and business professionals across all disciplines. Today at Penn ... Are you living your life's work? **Job Title:** Accounts Resolution Specialist I **Department:** RAD-O-BRO Data Acct Receivable **Location:** Fully Remote **Hours:**… more
- UPMC (Pittsburgh, PA)
- UPMC is seeking to hire a Certified Coding Specialist I to join our Coding Department. This is a work-from-home position, working Monday through Friday during ... five years of coding experience. As a Certified Coding Specialist I, you will have the same responsibilities as...and existing staff. Specifically, you will be working on denials , special projects in targeted specialties to assist in… more
- UPMC (Pittsburgh, PA)
- …the area of authorization related activities including pre-authorizations, notifications, edits, denials , etc. The Authorization Specialist shall demonstrate the ... UPMC Digestive Health Care is hiring a full-time Authorization Specialist to join their team at Shadyside Medical Building, Pittsburgh! In this position, you will… more
- Guthrie (Sayre, PA)
- Position Summary: Fulfills all requirements of Insurance Specialist I, as well as serving as a group leader by participating in staffing and employment issues. ... Serves as a resource specialist within the department. Trains Insurance Billing Specialists I...for the position. Essential Functions: 1. Identifies and evaluates denials for assigned payers and/or specialties to determine specific… more
- Commonwealth of Pennsylvania (PA)
- Drug & Alcohol Case Management Specialist (Local Government) - Delaware County D&A Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5144215) ... Apply Drug & Alcohol Case Management Specialist (Local Government) - Delaware County D&A Salary $48,896.00 Annually Location Delaware County, PA Job Type Civil… more
- WellSpan Health (Chambersburg, PA)
- …identification and investigation of issues related to precertification, reimbursement, denials , insurance availability, etc., and promptly notifies physician. + ... required time frames. + (BHU Only) Completes variances and/or denials report and UR Module functionality in a timely...- (Inpatient Rehab only) Assess patients for eligibility and clinical needs for post-acute inpatient services: - Completes the… more
- UPMC (Pittsburgh, PA)
- …Pediatric Ophthalmology, Strabismus, and Adult Motility is hiring a full-time Authorization Specialist to support their team located at UPMC Children's Hospital of ... the highest level of care to patients and families through clinical expertise, research initiatives, and strong administrative support. **Responsibilities:** + Prior… more