• Payment Integrity Clinician

    Highmark Health (Harrisburg, PA)
    …and retrospective claims review basis. Review process includes a review of medical documentation, itemized bills, and claims data to assure appropriate level of ... member satisfaction. Will be expected to identify potential discrepancies in provider billing practices and intervene for resolution and education or if necessary… more
    Highmark Health (11/14/25)
    - Related Jobs

  • Associate Investigator

    Highmark Health (Pittsburgh, PA)
    …Must have knowledge of provider facility payment methodology, claims processing systems and coding and billing proficiency + Must have understanding of technical ... to prevent further improper payments. Forwards case to the Credentialing and/or Medical Review Committee, law enforcement and regulatory agencies. + Develop and… more
    Highmark Health (12/18/25)
    - Related Jobs

  • Lead Radiation Therapist - ONC - (Radiation…

    UPMC (Monroeville, PA)
    …following areas: Administration/Management, Education/International, Quality/Regulatory, and Billing / Coding .Licensure, Certifications, and Clearances:ARRT ... Reinforces patient education/side effect management information and indicates non-compliance to medical /nursing staff. + Assists the Chief Therapist in evaluation of… more
    UPMC (12/18/25)
    - Related Jobs

  • Patient Access Team Lead / Emergency Department…

    Highmark Health (Pittsburgh, PA)
    …responsibility. (20%) + Identifies and resolves registration, scheduling, insurance verification, coding , and billing issues and takes appropriate action within ... and experience + 3-5 years of related experience, preferably within a medical setting, financial services setting, and/or a demanding customer service environment +… more
    Highmark Health (12/13/25)
    - Related Jobs

  • Manager, Practice Operations, Tamaqua Primary Care

    St. Luke's University Health Network (Tamaqua, PA)
    …patient experience. + Partners with other organizational functions (eg, Billing / Coding , Facilities/Property Management, Hospital Entity departments, Access ... customer service focus + Shares a compelling strategy that inspires others Medical practice management experience in across key areas: business operations, financial… more
    St. Luke's University Health Network (12/09/25)
    - Related Jobs

  • Case Manager

    PSKW LLC dba ConnectiveRx LLC (Pittsburgh, PA)
    …and provider interactions. + Keeps up to date with reimbursement process, billing / coding nuances, insurance plans, payer trends, financial assistance programs, ... access to essential medications! We seek a compassionate individual to engage with Medical Insurance Payers and Pharmacy Benefit Managers, playing a vital role in… more
    PSKW LLC dba ConnectiveRx LLC (10/10/25)
    - Related Jobs

  • Senior Lead - VOIP Engineer

    Sprinklr (PA)
    …major incidents + Collaborate with Backend and API teams to design provisioning, billing , and call analytics APIs + Evaluate and onboard open-source tools or ... in: + **C/C++ development** for real-time systems (not just architecture-active coding is required). + **VoIP protocols** : SIP signaling, SDP negotiation,… more
    Sprinklr (12/21/25)
    - Related Jobs

  • Data Scientist/ Senior Data Engineer - Finance…

    Guardian Life (Bethlehem, PA)
    …model, LTD Reserving model) + Automate manual actuarial/finance processes by integrating coding workflows with structured datasets and business logic + Support use ... structure financial and actuarial datasets from multiple sources (eg, Claims systems, Billing and Commissions system) + Implement robust data quality checks and… more
    Guardian Life (12/13/25)
    - Related Jobs

  • SAP Finance Manager, Application Development…

    Cardinal Health (Harrisburg, PA)
    …drive business value. Application Development & Maintenance performs configuration or coding to develop, enhance and sustain the organization's software systems in ... SAP Finance domain + Prior work experience in SAP Billing and Revenue Innovation Management (BRIM) is a plus...benefits and programs to support health and well-being. + Medical , dental and vision coverage + Paid time off… more
    Cardinal Health (12/02/25)
    - Related Jobs