- AscellaHealth (Berwyn, PA)
- …Independent Review Entities or other levels of the Appeals process. + Assist with internal and external audit processes. + Work with assigned clients to assess ... What we are looking for Optime Care seeks a Prior Authorization and Appeals Specialist for our Berwyn, PA location. We are looking for someone who is passionate… more
- Aegon Asset Management (Philadelphia, PA)
- …Corporate , which includes Finance, People and Places, General Counsel, Risk, Internal Audit , Strategy and Development, and Corporate Affairs, which covers ... For more information, visit transamerica.com . Job Description Summary The Specialist Enterprise Architecture will support technology for WFG (World Financial Group)… more
- Wabtec Corporation (Duquesne, PA)
- …with?** You will work with a broad range of talented individuals to deliver quality products in a timely manner at our Thermal Transfer Division business unit. ... You'll work alongside Engineering, Quality , and Production personnel and partner with professionals across...will be responsible for providing services and support to internal and external customers and suppliers to ensure materials,… more
- The Hershey Company (Hershey, PA)
- …and/or implements training programs to assure compliance and understanding of internal quality expectations and regulatory compliance. * Incident Management: ... * Job Location: Hershey PA or Remote* * Summary:* Serves as Quality & Regulatory Compliance (QRC) representative for Hershey Owned facilities and Hershey Salty… more
- Cardinal Health (Harrisburg, PA)
- …patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to ... Must demonstrate a superior willingness to help external and internal customers + First point of contact on inbound...any payer issues to the appropriate team + Must self- audit activities to ensure accuracy and efficiency for the… more
- Highmark Health (Pittsburgh, PA)
- …and programs as necessary; may have budgetary responsibility and authority. + Quality Improvement Specialist (QIS) Program:Vision and direction for leading ... Executes audits performed by government agencies (eg, CMS, HHS), internal Compliance and other validation audits to ensure efficacy...quality review of validation leading up to external audit of Highmark Inc. financial statements. + Vendor … more
- Guthrie (Sayre, PA)
- …Perform observational audits and medical record analysis as needed as part of the quality audit function. + Use verbal and written communication skills to ... Position Summary: The Quality Improvement Specialist -Registered Nurse (QIS-RN) supports...Skills: + Demonstrated Project Management, Analytical, Customer Service, Computer, Audit Function, Organization, Communication and Data Analysis skills +… more
- ELLWOOD NATIONAL FORGE CO (Irvine, PA)
- …throughout the organization. The successful candidate will supervise team members in Quality Specialist and Quality Engineering roles and contribute ... relevant manufacturing quality standards. + Conduct regular internal quality audits and prepare for external...detailed records of inspections, test results, inspector certifications and quality audit results. + Prepare and present… more
- CVS Health (Harrisburg, PA)
- …regulators and vendor coding resources. + Acts as mentor to provide education to internal staff based on audit findings; provides general education on ICD codes ... Aetna's Revenue Integrity team is hiring Senior Coding Data Quality Auditors to support our growing risk adjustment efforts.... inter-rater review audits of medical records coded by internal team, as well as external vendor (if applicable)… more
- Highmark Health (Harrisburg, PA)
- …Health Network **Job Description :** **GENERAL OVERVIEW:** Performs all related internal , concurrent, prospective and retrospective coding audit activities. ... identified in the audits compliant with regulatory requirements. Provides written audit guidance. Participates with management in the assessment of external … more