• Director Risk Adjustment, Coding & Quality

    Highmark Health (Pittsburgh, PA)
    …- 5 years in Operational Excellence **LICENSES AND CERTIFICATIONS** **Required** + AAPC, Certified Professional Coder ( CPC ) **Preferred** + AAPC, ... Assurance on RPM Programs coding results: Lead team of coder / clinicians to review member medical records...Certified Risk Adjustment Coder (CRC) **SKILLS** + CMS Regulations + Presentation Delivery… more
    Highmark Health (08/08/25)
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  • Quality Senior Analyst

    CVS Health (PA)
    …history/on the job experience equal to approximately 5 years for CPC . + CPC ( Certified Professional Coder ) **or** CCS-P ( Certified Coding ... Certified Risk Adjustment Coder ) required. + CPMA ( Certified Professional Medical Auditor) **or** CDEO ( Certified Documentation Expert Outpatient)… more
    CVS Health (09/30/25)
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  • Coding Data Quality Auditor

    CVS Health (Harrisburg, PA)
    …experience in medical record documentation review, diagnosis coding, and/or auditing. + CPC ( Certified Professional Coder ) or CCS-P ( Certified Coding ... Specialist-Physician) required. + CRC ( Certified Risk Adjustment Coder ) + Computer proficiency including experience with Microsoft Office products (Word, Excel,… more
    CVS Health (09/27/25)
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  • Ambulatory Coding and Doc Specialist

    Penn Medicine (Bala Cynwyd, PA)
    …position is to improve the accuracy of coding, compliance and clinical documentation. The Certified coder ( CPC or CCS-P) is responsible for detailed analysis ... the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and...be considered in lieu of degree. + CCS or Certified Procedural Coder - CPC more
    Penn Medicine (08/07/25)
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  • Investigations Consultant

    Highmark Health (Pittsburgh, PA)
    …or CERTIFICATIONS** **Required** + None **Preferred** + Certified Fraud Examiner (CFE) + Certified Professional Coder ( CPC ) + Certified Professional ... professional, hospital, ambulatory surgical center, home health and durable medical equipment to identify key areas of risk exposure...Coder - Hospital( CPC -H) + Certified Outpatient Coder (COC) + Accredited Healthcare… more
    Highmark Health (08/22/25)
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  • Facility Coding Inpatient DRG Quality

    Banner Health (PA)
    Certified Coding Specialist (CCS) or Certified Inpatient Coder (CIC) or Certified Professional Coder ( CPC ) or Certified Outpatient Coder ... you. **Requirements:** + **5 years recent experience in acute-care Inpatient facility-based medical coding (clearly reflected in your attached resume);** + **DRG and… more
    Banner Health (09/06/25)
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  • Investigator

    Highmark Health (Harrisburg, PA)
    …+ None **Preferred** (any of the following) + Certified Fraud Examiner (CFE) + Certified Professional Coder ( CPC ) + Certified Outpatient Coder ... to prevent further improper payments.Forwards case to the Credentialing and/or Medical Review Committee, law enforcement and regulatory agencies. + Responsible for… more
    Highmark Health (09/10/25)
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  • Auditor, HCC Risk Adjustment Coding - Full Time…

    Datavant (Harrisburg, PA)
    …to realize our bold vision for healthcare. As an Auditor, HCC Risk Adjustment Coder , you will review medical records to identify and code diagnoses using ... diploma or GED equivalent + AHIMA certified credentials (RHIA, RHIT, CCS) or AAPC certified credentials ( CPC , CPC -H, COC, CIC or CRC). + Proficient in… more
    Datavant (08/08/25)
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  • PB Coding Coordinator

    Intermountain Health (Harrisburg, PA)
    …line + Preferred seven plus (7+) years of related coding experience + Required credential: CPC Certified Professional Coder ( CPC ) or Certified ... Charge Review, Claim Edit, and Follow-up work queues in Epic. + Review medical record documentation and assign appropriate CPT, HCPCS, ICD-10, and modifiers. +… more
    Intermountain Health (09/26/25)
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  • Coding Audit & Education Coordinator

    St. Luke's University Health Network (Allentown, PA)
    …(RHIT); Registered Health Information Administrator (RHIA); Certified Professional Auditor (CPMA); Certified Professional Coder ( CPC ); Certified ); ... coding audit activities. The incumbent will also review and validate coded medical records of the Professional Coding (PC) staff to determine data quality… more
    St. Luke's University Health Network (08/20/25)
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