- Highmark Health (Pittsburgh, PA)
- …specific to professional, hospital, ambulatory surgical center, home health and durable medical equipment to identify key areas of risk exposure and develop plans ... hospital or health insurance setting + 5 years in professional billing , facility Patient Financial Services, HIM, Internal Audit, Professional/Facility Reimbursement… more
- Cardinal Health (Harrisburg, PA)
- …(technical) services, including: detection and correction of documentation, coding, and billing errors and/or medical necessity of services billed. Particular ... documentation and coding related to physician or hospital (inpatient and outpatient) billing and/or medical necessity reviews. + Manages focused audits involving… more
- Highmark Health (Harrisburg, PA)
- …to prevent further improper payments.Forwards case to the Credentialing and/or Medical Review Committee, law enforcement and regulatory agencies. + Responsible for ... to internal and external law enforcement and regulatory agencies, Credentialing or Medical Review Committee. + Engages in delivery of audit results and overpayment… more
- Redeemer Health Home Care & Hospice (Huntingdon Valley, PA)
- …AAPC or AHIMA Certification (CPC, CRC, CCS) REQUIRED + Certified Risk Adjustment Coder - PREFERRED Knowledge + Knowledgeable of medical and clinical terminology, ... long-term success including education assistance, scholarships, and career training. With medical and dental coverage, access to childcare & fitness facilities on… more
- UPMC (Pittsburgh, PA)
- …offices as needed. In this role, you will be responsible for reviewing medical charts to identify opportunities for process improvement. You will conduct audits to ... suggestions for operational improvements. + Utilize advanced, specialized knowledge of medical codes and coding procedures to assign and sequence appropriate… more
- Guthrie (Sayre, PA)
- …understand and adhere to revenue integrity standards, including coding, billing , documentation, and compliance requirements. The trainer collaborates with subject ... - Minimum of 3-5 years of experience in healthcare revenue cycle, coding, billing , or compliance - Experience in developing and delivering training programs -… more
- Datavant (Harrisburg, PA)
- …for reviewing records via client's auditing tool, updating coding and submitting for billing . Evaluator experience a plus. **What You Will Do:** + Performs Inpatient ... to ensure optimal workflow and turnaround time + Provides coder education via the auditing process + Function in...via client's auditing tool, updating coding and submitting for billing . Evaluator experience a plus. + 5+ years of… more
- UPMC (Pittsburgh, PA)
- …role, the DRG Specialist II will review clinical documentation within the medical record to ensure that all patient resource utilization, diagnostic complications ... of care. + Review and evaluate focused UPMC DRG medical records for accurate DRG assignment to ensure that...sequenced according to coding and compliance guidelines. + Review billing data when conducting focused chart audits to ensure… more
- Penn Medicine (Philadelphia, PA)
- …leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across ... professional fee coding across all entities to ensure timely and optimal billing and reimbursement to support established Health Information Management and Revenue… more
- St. Luke's University Health Network (Allentown, PA)
- …coding audit activities. The incumbent will also review and validate coded medical records of the Professional Coding (PC) staff to determine data quality ... and accuracy of coding, billing , and documentation related to DRG's, CPT, APC's, and...a time. Repetitive arm/finger use for retrieving/viewing computerized patient medical records and abstracting information. Extended periods of vision… more