- Highmark Health (Blue Bell, PA)
- …for risk revenue management for all government program products (commercial ACA, Medicare , and Medicaid). Establishes the strategic direction for the Risk Revenue ... comprehensive and accurate diagnosis coding for risk adjusted government programs ( Medicare Advantage, ACA business, and Medicaid). Also work with Care Management… more
- Banner Health (PA)
- …to our award-winning patient care. POSITION SUMMARY This position evaluates medical records, provides clinical and surgical abstraction for full range of ... department projects, validation edits and/or revisions. CORE FUNCTIONS 1. Analyzes medical information from medical records. Accurately codes diagnostic and… more
- Humana (Harrisburg, PA)
- …of our caring community and help us put health first** The Senior Inpatient Medical Coding Professional extracts clinical information from a variety of medical ... in-depth evaluation of variable factors. **Responsibilities** The Senior Inpatient Medical Coding Professional confirms appropriate diagnosis related group (DRG)… more
- Fresenius Medical Center (Camp Hill, PA)
- …**Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans** ... nurse in accordance with organization policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal… more
- Banner Health (PA)
- …Medicine, Physician Practice Coding Team** is looking for an **experienced Medical Coder with General Medicine: Multi-Specialty experience.** This is a skilled ... for contributing to our award-winning patient care. POSITION SUMMARY Evaluates medical records, provides clinical and surgical abstraction and assigns appropriate… more
- CVS Health (Harrisburg, PA)
- …collaborative environment focused on ensuring accurate member eligibility verification and compliance with CMS (Centers for Medicare & Medicaid Services) ... seeking a Senior Coordinator, Accounting to join our dynamic Medicare Risk Adjustment Team. This full-time role offers the...payments and report on ESRD special status. + Ensure compliance with CMS deadlines and reporting requirements. + Work… more
- BAYADA Home Health Care (Philadelphia, PA)
- …supervision and support to field RNs, LPNs, and clinical staff + Ensure compliance with Medicare Conditions of Participation (CoPs), state regulations, and ... to fill the position of **Clinical RN Nurse Manager** for our **Philadelphia, PA** Medicare Certified, Home Health office. Do you want to be part of providing care… more
- Evolent (Harrisburg, PA)
- …platforms. + No current exclusions, sanctions, or disciplinary actions by **state or federal healthcare programs ( Medicare , Medicaid, OIG, or GSA).** Join us at ... for the culture. **What You'll Be Doing:** Evolent is seeking an **Associate Medical Director - Cardiovascular Medicine** to play a critical role in **Performance… more
- CVS Health (Harrisburg, PA)
- …requirements. + Comprehensive knowledge of coding guidelines and regulations to meet compliance requirements, such as establishing medical necessity. + Identify ... Responsible for conducting complex audits, reviews and assessments of medical records coded by internal teams prior to the...teams prior to the submission to the Centers of Medicare and Medicaid Services (CMS) for the purpose of… more
- Prime Therapeutics (Harrisburg, PA)
- …specialized needs of the targeted population; for Medicare , is Centers for Medicare & Medicaid Services (CMS) compliance compliant + Utilize Prime's MTM ... all lines of business to support the Centers for Medicare & Medicaid Services (CMS) Star and HEDIS quality...in healthcare industry + Experience working with highly confidential medical information + CPhT certification + Fluency in another… more