- St. Luke's University Health Network (Allentown, PA)
- …patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials for medical necessity and tracks outcomes ... appeal process. Assists billing staff regarding outpatient denials for experimental, coding or other issues that may require record review. Provides billing… more
- Humana (Harrisburg, PA)
- …participation in care management. The clinical scenarios predominantly arise from inpatient or post-acute care environments. Has discussions with external physicians ... require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient… more
- Datavant (Harrisburg, PA)
- …+ Conduct timely, accurate, and complete documentation reviews for selected inpatient records, addressing inadequate or conflicting documentation. + Collaborate with ... secondary diagnoses, and procedure impact on DRG. + Improve coding specificity by educating physicians and caregivers on the...throughout a patient's stay. + Follow AHA guidelines and coding clinics for accurate coding and required… more
- Penn State Health (Hershey, PA)
- …care including but not limited to Skilled Nursing Facilities (SNF) and inpatient rehabilitation facilities (IRF) and home health agencies (HHA). External partners ... supervise, and perform medical record audits of electronic and manual documentation, coding , and billing for technical and professional services. + Develop formal… more
- Humana (Harrisburg, PA)
- …participation in care management. The clinical scenarios predominantly arise from inpatient or post-acute care environments. The medical director has discussions ... require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient… more
- LifePoint Health (Johnstown, PA)
- …skills. Process improvement in an acute care facility preferred or equivalent experience- coding skills with knowledge of CMS Inpatient Prospective Payment System ... and working knowledge of AHA Coding Clinic. *Preferred:*Certified Clinical Documentation Improvement Specialist (CCDS) or Certified Documentation Improvement (CDIP)… more
- ChenMed (Philadelphia, PA)
- …physicians/clinicians needs or outstanding items regarding to patients. + Enters all Inpatient and Outpatient elective procedures in HITS tool. + Ensures patient's ... timely complete tasks. Knowledge of medical terminology, CPT, HCPCS and ICD coding preferred. **KNOWLEDGE SKILLS AND ABILITIES:** + Knowledge of medical terminology,… more
- Trinity Health (Woodlyn, PA)
- …when necessary. Oversees and manages participant's use of medical specialist and inpatient care. Communicates and follows up with specialist regarding outcome of ... of participants. + Complete documentation timely and uses appropriate diagnostic coding . Respond to coding department in a timely manner. + Advise the Medical… more
- ChenMed (Philadelphia, PA)
- …physicians/clinicians needs or outstanding items regarding to patients. + Enters all Inpatient and Outpatient elective procedures in HITS tool. + Ensures patient's ... + Knowledge of medical terminology, CPT, HCPCS and ICD coding desired + Detail-oriented with the ability to multi-task....+ Knowledge of medical terminology, CPT, HCPCS and ICD coding desired + An understanding of the company's patient… more
- Humana (Harrisburg, PA)
- …models and develop new tools which support strategic decision-making. Technical expertise and coding experience a key skill needed for this role, as daily activities ... will involve creating, modifying, and reviewing logic in various coding platforms. This role involves collaboration with stakeholders to understand business needs… more