• Provider Services Auditor

    St. Luke's University Health Network (Allentown, PA)
    …meet with providers to perform education for the professional service documentation and coding audits of both office and in-patient medical records. + Maintain ... of job. EDUCATION AND TRAINING: High school diploma or equivalent required. Certification of CPC , CCS, or CCS-P highly desired OR Coding certification within one… more
    St. Luke's University Health Network (09/04/25)
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  • Compliance Auditor, Associate

    UPMC (Pittsburgh, PA)
    …or comparable technical school diploma is preferred. + 1 year of experience in medical coding , auditing, billing and compliance. + Knowledge of CMS and ... Auditing:** Conduct UPMC-wide auditing and monitoring to ensure that coding /documentation combinations and medical record documentation adequately support… more
    UPMC (07/24/25)
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  • Insurance Specialist II - Corporate Patient AR…

    Guthrie (Sayre, PA)
    …diploma or equivalency required. CPC , CCA, RHIA, RHIT certification in medical billing and coding or Associates degree preferred. Experience: Minimum 3 ... years experience in insurance billing or CPC certified. Must demonstrate current competencies applicable to the...to the team environment. Must maintain a knowledge of medical terminology, CPT and IC D‐10 Coding … more
    Guthrie (09/11/25)
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  • Coder I - Risk Adjustment, Geisinger Health Plan…

    Geisinger (Danville, PA)
    …qualified individuals to apply. Position Details Coder level II requires minimum one coding certification: CPC - Certified Professional Coder CRC - Certified Risk ... Job Summary Risk Adjustment coding is the transformation of verbal descriptions of...diagnoses. Job Duties + Reviews the content of the medical record for hospital and professional inpatient and outpatient… more
    Geisinger (09/22/25)
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  • Per Diem Professional Fee PA/NJ Remote Coder

    St. Luke's University Health Network (Allentown, PA)
    …information into specialty- specific databases. + Conducts educational sessions to the medical staff for coding and documentation compliance. PHYSICAL AND ... entry of physician services statistics into specialty-specific databases. Works with Medical Records, Finance, and Physician Billing to ensure appropriate flow of… more
    St. Luke's University Health Network (09/26/25)
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  • HCC Risk Adjustment Coder - Full Time - Remote

    Datavant (Harrisburg, PA)
    …healthcare. As an HCC (Hierarchical Condition Category) coder you will review medical records to identify and code diagnoses using a standardized system, ensuring ... Review, analyze, and code diagnostic information in a patient's medical record based on client specific guidelines for the...guidelines. + Coders must meet and maintain a 95% coding accuracy rate. + Any other task requested by… more
    Datavant (08/26/25)
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  • Certified Oncology Coder

    Redeemer Health Home Care & Hospice (Meadowbrook, PA)
    …department in coordination of the Charge Master to design the capture of associated coding and billing for radiation and medical oncology. Works cooperatively as ... service we provide. RECRUITMENT REQUIREMENTS Successful completion of Certified Coding Exam required; CCS or CPC . Oncology.... Oncology Certification a plus. Additionally, three years of medical oncology coding experience preferred or in… more
    Redeemer Health Home Care & Hospice (08/13/25)
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  • Denials Prevention Specialist PRN

    Datavant (Harrisburg, PA)
    …and manage denials throughout the entire revenue cycle, including registration, eligibility, coding , billing, and medical necessity. + Analyze denial trends and ... This role requires in-depth knowledge of healthcare revenue cycle processes, HIM coding practices, and proficiency in multiple electronic systems and software tools.… more
    Datavant (09/30/25)
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  • Investigations Consultant

    Highmark Health (Pittsburgh, PA)
    …specific to professional, hospital, ambulatory surgical center, home health and durable medical equipment to identify key areas of risk exposure and develop plans ... None **Preferred** + Certified Fraud Examiner (CFE) + Certified Professional Coder ( CPC ) + Certified Professional Coder- Hospital( CPC -H) + Certified Outpatient… more
    Highmark Health (08/22/25)
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  • Insurance Specialist I - Corporate Patient AR Mgmt…

    Guthrie (Towanda, PA)
    …High school diploma required; CPC , CCA, RHIA, RHIT certification in medical billing and coding or Associates degree preferred. Experience: Strong ... up with payers on unresponded claims. Works denied claims by following correct coding and payer guidelines resulting in appeal or charge correction. Teams with… more
    Guthrie (09/23/25)
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