• Insurance Verification Representative - PGC…

    Surgery Care Affiliates (Philadelphia, PA)
    …guidelines in contacting patient's prior to the date of service to review , Physician Ownership, Advance Directives and Patient Rights. Authorization: + Obtain ... payable, notify patient. If patient wants to proceed, obtain signature on Medicare ABN or other non-covered notification form. Financial Orientation: + Calculate… more
    Surgery Care Affiliates (05/29/25)
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  • RN Diabetes Coordinator - Endocrinology - Full…

    Guthrie (Sayre, PA)
    …promoting outreach: currently RPH AD Hoc outreach committee e. Development and review brochures and educational materials for outlying offices f. Ongoing development ... and review Diabetes Specific Information for Guthrie website g. Speakers...members of patient progress e. Billing of services per ADA/ Medicare Guidelines f. Completion of POCT testing and documentation… more
    Guthrie (06/24/25)
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  • DRG Specialist

    UPMC (Pittsburgh, PA)
    …role requires three years of coding experience. In this role, you will review clinical documentation within the medical record to ensure that all patient resource ... with coding guidelines, third-party payer and OIG regulations. **Responsibilities:** + Review and evaluate focused UPMC DRG medical records for accurate DRG… more
    UPMC (06/11/25)
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  • RN Clinical Manager

    CenterWell (Lancaster, PA)
    …audits/billing are completed timely and in compliance with Medicare regulations. + Coordinates communication between team members/attending physicians/caregivers ... + Assesses staff education needs based on own the review of clinical documentation in addition to feedback and...documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and… more
    CenterWell (08/16/25)
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  • HIM Clinical Documentation Specialist

    Penn Medicine (Philadelphia, PA)
    …and/or specification to reflect truth in diagnostic reflection. Responsibilities: + Direct review of patient charts to audit clarity and full reflection of severity ... develop/upkeep efficiencies/synergies within the Clinical Documentation department + Enter clinical review data and related anticipated follow-up in EPIC PENN Chart… more
    Penn Medicine (08/07/25)
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  • Skilled Nursing Administrator

    Sunrise Senior Living (Haverford, PA)
    …their work assignments in accordance with acceptable Sunrise and nursing standards. + Review and act upon any complaint or concern as they arise. + Participate ... to care planning team. + Oversee the process and review care plans and assessments as necessary at least...care management and skilled nursing environment + Proficiency in Medicare , Minimum Data Sheets (MDS) / Resident Assessment Instrument… more
    Sunrise Senior Living (07/18/25)
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  • Medical Assistant - Heart & Vascular Center

    WellSpan Health (York, PA)
    …sheets etc.). + Obtains comprehensive health information from patient/family members to review with providers or clinical resource over the phone. Uses this ... information from patient/family members at the time of the visit. This may include review of systems and history of present illness and/or past medical and social… more
    WellSpan Health (08/16/25)
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  • Director Risk Adjustment, Coding & Quality

    Highmark Health (Pittsburgh, PA)
    …with all applicable guidelines, regulations and laws established by the Centers for Medicare and Medicaid Services (CMS), the Department of Health and Human Services ... Programs coding results: Lead team of coder/ clinicians to review member medical records to validate 100% of new...for reimbursement.Oversee operations to track and validate multi-pass quality review of validation leading up to external audit of… more
    Highmark Health (08/08/25)
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  • Medical Assistant - Family Medicine Philadelphia…

    WellSpan Health (Chambersburg, PA)
    …sheets etc.). + Obtains comprehensive health information from patient/family members to review with providers or clinical resource over the phone. Uses this ... information from patient/family members at the time of the visit. This may include review of systems and history of present illness and/or past medical and social… more
    WellSpan Health (08/08/25)
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  • Residency Program Coordinator - Full Time…

    Trinity Health (Philadelphia, PA)
    …physician offices and other institutions for Intern and Resident rotations, necessary for Medicare Regulations. Each letter of Agreement must be signed and dated by ... process for appointment to the hospitals. Assists with quota review and rank list entry and certification in Residency...duty hours, patient logs and procedure logs via regular review of data reports. Organizes meetings and prepares and… more
    Trinity Health (08/08/25)
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