- Datavant (Harrisburg, PA)
- …to realize our bold vision for healthcare. As an Auditor, HCC Risk Adjustment Coder , you will review medical records to identify and code diagnoses using ... a standardized system , ensuring accurate representation of patient conditions for risk...Medicare, commercial, and Medicaid sectors. + In-depth knowledge of medical terminology, abbreviations, pharmacology, and disease processes. + Ability… more
- Evolent (Harrisburg, PA)
- …a related field or equivelent years of work experience. + **Certification in medical coding (CRC- Certified Risk Adjustment Coder ) or demonstrated ability.** + ... seek to connect the pieces of fragmented health care system and ensure people get the same level of...Coding Manager plays a crucial role in ensuring accurate medical coding and compliance with risk adjustment models. **What… more
- Banner Health (PA)
- …you. **Requirements:** + **5 years recent experience in acute-care Inpatient facility-based medical coding (clearly reflected in your attached resume);** + **DRG and ... documentation and its impact on reimbursement under Medicare Severity Adjusted System (MS-DRG),All Payer Group (APR-DRG) and Ambulatory Payment Classification (APC)… more
- 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 ... claims were adjusted correctly, resulting in expected recovery/savings. + Perform claims system extracts and create reports, graphs, and charts to timely identify… more
- Penn Medicine (Bala Cynwyd, PA)
- …leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across ... to improve the accuracy of coding, compliance and clinical documentation. The Certified coder (CPC or CCS-P) is responsible for detailed analysis of out-patient … 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, ... success including education assistance, scholarships, and career training. With medical and dental coverage, access to childcare & fitness...light of the Mission & Values of the Health System . Regardless of position, every job contributes to the… 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
- 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 ... issues. + Analyzes coding data audits to identify trends within the hospital system , and identify areas of opportunity or assess potential compliance risks. +… more
- Guthrie (Sayre, PA)
- …population, in accordance with the established standards of the Pennsylvania Trauma Systems Foundation, (PTSF) and in conjunction with the standards and policies of ... & Cert: + Registered Health Information Technician Degree or Certified Professional Coder Certification preferred. + Associates degree in related field is preferred.… 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 ... performed during an episode of care. + Review and evaluate focused UPMC DRG medical records for accurate DRG assignment to ensure that all documented principal and… more
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