- Highmark Health (Pittsburgh, PA)
- …fulfill CMS audit requests.Includes retrieval of medical records, validation of member clinical conditions and confirmation of reimbursement values received from ... to deliver the highest quality of care to Highmark members and improve clinical documentation accuracy and completeness. Creates a culture focused on Compliance and… more
- Guthrie (Sayre, PA)
- …Gastroenterology and Pulmonary Critical Care Fellowship programs. Guthrie is also a clinical campus for the Geisinger Commonwealth School of Medicine. ... Communicate with departments/sites when expected charge tickets have not been received for entry. Works closely with Central Charge Manager and Centralized Charge Entry Lead to identify missing charges not received in a timely manner. Education, License &… more
- Guthrie (Sayre, PA)
- … Systems, Case Management, Regulatory Compliance, Population Health, Value Based Reimbursement , Policy Management, Clinical Service Departments and other ... Gastroenterology and Pulmonary Critical Care Fellowship programs. Guthrie is also a clinical campus for the Geisinger Commonwealth School of Medicine. more
- WellSpan Health (Lebanon, PA)
- …charge, as well as eclectic selection of CEU training topics that support clinical growth and competency + Licensure reimbursement + Bonus opportunity available ... dynamic team of clinicians from a vast array of clinical training programs and disciplines who are passionate about...Gretna or York + Regular group supervisions and additional clinical consult available as needed + Required trainings for… more
- Guthrie (Sayre, PA)
- …outcomes. Identifies opportunities to continue or reduce costs and optimize case reimbursement . a) Identifies cost/ clinical outlier patients for intensive case ... Case Manager utilizes industry accepted processes for achieving optimal patient, clinical , and operational outcomes timely, coordinated, and in cost effective… more
- UPMC (Media, PA)
- …reviewer for cases referred by care management staff. + Focus on clinical documentation improvement efforts thereby improving reimbursement rates. + Interfaces ... assuring the adequacy of the provider network for the clinical needs of Community Care members. The Medical Director...providers in its network. + Ensures the quality of clinical care provided to Community Care members. + Focus… more
- Penn Medicine (Lancaster, PA)
- …support, and patient/family education. * Complies with all billing and reimbursement procedures. * Supervises the clinical practicum for graduate ... Working for this leading academic medical center means collaboration with top clinical , technical and business professionals across all disciplines. Today at Penn… more
- UPMC (Pittsburgh, PA)
- …the BU and solve problems and identify resources related to insurance coverage and reimbursement issues for all BU community-based BU. + Create a culture of service ... goals. Assist with the supervision and oversight of the BU budgets (ie, clinical practice plan, hospital, School of Medicine, and research). Assist the Administrator… more
- J&J Family of Companies (Horsham, PA)
- …so, the CMAL will shape key strategic decisions through input/contributions to Clinical Development and Integrated Evidence Generation Plans to ensure that strategic ... Extended Market Access Team (EMAT) to support timely, optimal reimbursement in a highly challenging environment across diverse regions...access strategies as an active member of the global clinical and commercial product teams, as well as the… more
- St. Luke's University Health Network (Allentown, PA)
- …affect proper documentation and coding of documented medical care for appropriate reimbursement . In collaboration with the appropriate clinical staff, including ... Analyze DRG or CPT denial letters and draft appeal letters, including supporting clinical documentation from record, supporting clinical evidence, and the coding… more