- Highmark Health (Pittsburgh, PA)
- …to Quality and Coding for the Highmark Health Enterprise. Ensures that Highmark's Risk Adjustment programs comply with all applicable guidelines, regulations and ... laws established by the Centers for Medicare and Medicaid Services (CMS), the Department of Health...a team of internal coder / clinicians that perform Risk Adjustment coding of medical records. Track… more
- St. Luke's University Health Network (Stroudsburg, PA)
- …to: RN care managers, assistants, coordinators, utilization management staff, and director . . Facilitates communication among all treatment team members. . Manages ... patient as healthy as possible in the outpatient setting, minimizing the risk of readmissions. . Issues applicable state/federal regulatory notices as applicable… more
- St. Luke's University Health Network (Quakertown, PA)
- …to: RN care managers, assistants, coordinators, utilization management staff, and director . + Facilitates communication among all treatment team members. + Manages ... patient as healthy as possible in the outpatient setting, minimizing the risk of readmissions. + Issues applicable state/federal regulatory notices as applicable… more
- Humana (Harrisburg, PA)
- …analyze large data sets + Knowledge of healthcare compliance, mainly primary care and risk adjustment , pharmacy knowledge a plus + Certified Coder (CPC, CRC, ... to assess, investigate, audit and validate the mitigation of compliance risk across the organization. This team ensures that healthcare providers align… more
- Penn Medicine (Bala Cynwyd, PA)
- …unit, department, entity, and health system organization Credentials: + Certified Risk Adjustment Coder certification. (Preferred) + Certified Procedural Coder ... as triggered by any internal/external benchmarking identified by Senior leadership, Director and Associate Director . + Prepares materials, appropriate research… more