- Cognizant (Philadelphia, PA)
- …House:** TriZetto offers product solutions to the healthcare industry from streamlining payer processes to automating insurance operations. The practice has its own ... ecosystem of businesses including positions in marketing, project management, and technical roles - such as developers and analysts. **Products include:** + Clinical CareAdvance and CareAdvance Provider + EngageMember + EngageProvider + Facets + NetWorX… more
- Evolent (Harrisburg, PA)
- …years of professional experience in claims-based healthcare analytics with a payer , provider, clinical vendor, managed care, or related healthcare consulting entity ... is preferred + Experience using data visualization software (s) to package analytical insights (Power BI, Tableau, or similar) is preferred + Familiarity with healthcare reimbursement methodologies and calculations such as DRGs, Revenue Codes, CPT Codes, RVUs,… more
- UPMC (Williamsport, PA)
- …as a resource for billing, quality, project support, analytics, and payer guidelines. + **Problem Solving:** Identify recurring problems and procedural deficiencies, ... providing effective solutions to eliminate them. + **Process Improvement:** Interact with the management team to suggest and implement process improvements. + **Root Cause Analysis:** Use root cause analysis to address processes that fail to meet departmental… more
- Select Medical (Philadelphia, PA)
- …business development team + Collect co-pays from patients, manage payer approvals, and conduct insurance authorizations and verifications **Qualifications** ... **Minimum:** + High School Diploma or GED **Preferred:** + Healthcare experience **Additional Data** _Equal Opportunity Employer/including Disabled/Veterans_ Apply for this job… more
- Evolent (Harrisburg, PA)
- …product marketing and related sales operations functions, preferably in healthcare payer /provider services companies . Proven track record of accomplishment on ... development and execution of marketing strategies . Excellent communication and interpersonal skills, adept at navigating senior-level stakeholder discussions . Experience building and developing team members . Knowledge of the managed care and oncology market… more
- Heritage Ministries (Conneautville, PA)
- …and completion of necessary functions to assure Medicare and other payer 's requirements are maintained in regards to clinical assessment and documentation. ... The MDS Coordinator will act as a coordinator of MDS, Medicare, and Restorative Nursing functions. This individual will work in conjunction with the Management Company's Clinical Reimbursement Case Manager, acting as a liaison to finance/billing, and assisting… more
- UPMC (Pittsburgh, PA)
- …coded accurately and completely in compliance with coding guidelines, third-party payer and OIG regulations. **Responsibilities:** + Review and evaluate focused UPMC ... DRG medical records for accurate DRG assignment to ensure that all documented principal and secondary diagnoses, including all complications and co-morbidities, and procedures are accurately coded and sequenced according to coding and compliance guidelines. +… more
- Penn State Health (Hershey, PA)
- …data within the patient's EMR. + Ability to understand third party payer and insurance complexities. + Ability to communicate professionally with all patients, ... peers, providers. + Ability to train new hires. + Ability to multitask due to the high volume of phone calls. + Ability to know and understand complex therapies. **WHY PENN STATE HEALTH?** Penn State Health offers exceptional opportunities to learn and grow,… more