• Coding Appeals Specialist

    St. Luke's University Health Network (Allentown, PA)
    …to, physicians, hospital employees and vendors. Advises Network CDI & DRG Denials Manager on issues requiring immediate attention. ADDITIONAL REQUIREMENTS: ... Per diem position is flexible upon request and with prior agreement with manager . Original: 8/16 Revised: 1/17 Revised: 10/24 Please complete your application using… more
    St. Luke's University Health Network (08/18/25)
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  • RN, Case Manager (Part time), Forbes

    Highmark Health (Monroeville, PA)
    …contractual requirements. + Documents, monitors, intervenes/resolves and reports clinical denials /appeals and retrospective payer audit denials . Collaboratively ... CERTIFICATIONS** **Required** + None **Preferred** + ACM Certification (Accredited Case Manager ) - American Case Management Association - American Case Management… more
    Highmark Health (08/12/25)
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  • Case Management Manager - UPMC

    UPMC (Washington, PA)
    The Manager oversees the day-to-day operations of the Case management department under the direction of the Director. The Manager is accountable for the ... training, auditing, systems support: Case Management Technology, InterQual, Concurrent Denials and reporting. Leads efforts to develop, implement, evaluate, redesign… more
    UPMC (07/11/25)
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  • Case Manager

    PSKW LLC dba ConnectiveRx LLC (Pittsburgh, PA)
    …and experience makes ConnectiveRx better than the sum of its parts. The Case Manager 's primary duty is to assist customers with chronic illnesses in their assigned ... to their wellbeing needs, journey and treatment plan. The Case Manager collaborates and maintains consistent communications with internal and external partners… more
    PSKW LLC dba ConnectiveRx LLC (09/03/25)
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  • Manager , Clinical Care Coordination…

    UPMC (Mechanicsburg, PA)
    The Manager oversees the day-to-day operations of the Clinical Care Coordination and Discharge Planning Department under the direction of the Director. The ... Manager is accountable for achieving established goals and targets...and accurate documentation of appropriate data relating to concurrent denials . Assures regulatory compliance in determining denial of service… more
    UPMC (06/06/25)
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  • Clinical Reimbursement Case Management…

    Genesis Healthcare (York, PA)
    …making a meaningful impact in the communities we serve. Responsibilities The Manager , Case Management is responsible for the clinical, administrative, and financial ... responding to the needs of its payor customers. The Manager will also perform the functions of the Case...for effectively addressing concurrent and retrospective clinical and administrative denials by payors and trains staff on same. 5.… more
    Genesis Healthcare (07/01/25)
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  • Patient Account Representative - Chambersburg…

    WellSpan Health (Chambersburg, PA)
    Position Function: Under the direction of the Patient Account Manager , is responsible for the billing of Medicare, Medical Assistance, Blue Cross, Highmark Blue ... that important deadlines are met. Informs Assistant Patient Account Manager of any problems which would prevent the timely...in a timely manner. 35. Meets department guidelines of Denials WQ as required. Track, trend and investigate … more
    WellSpan Health (08/29/25)
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  • Claims and Denial Coding Analyst

    St. Luke's University Health Network (Allentown, PA)
    …clean claim submission and timely review and resolution of coding related claim denials for professional services, FQHC, MSO, and ASCs across the network. Utilizes ... coding errors and MUE frequency for clean claim submission + Resolve coding denials through claim correction or appeal. Claim corrections will be made after review… more
    St. Luke's University Health Network (08/19/25)
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  • AR Representative

    Penn Medicine (Limerick, PA)
    …changes to billing policies. + Reviews, processes and challenges all rejections and denials escalating notable trends to the Practice Manager + Identifies issues ... third party payers. The AR Rep assists the practice manager and providers in maintaining a patient/customer focus, supports...workqueues within the designated benchmark. + Meets regularly with Manager to review status of A/R, special projects, and… more
    Penn Medicine (08/09/25)
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  • AR Representative

    Penn Medicine (Berwyn, PA)
    …changes to billing policies. + Reviews, processes and challenges all rejections and denials escalating notable trends to the Practice Manager + Identifies issues ... third party payers. The AR Rep assists the practice manager and providers in maintaining a patient/customer focus, supports...workqueues within the designated benchmark. + Meets regularly with Manager to review status of A/R, special projects, and… more
    Penn Medicine (08/07/25)
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