- Guthrie (Sayre, PA)
- Option to be Hybrid/Remote. Summary: A senior level compliance coding auditor conducting assessments in accordance with The Guthrie Clinic's policies and ... guidelines, payer guidelines and requirements. + Minimum 1-year experience in Physician coding and billing and/or compliance field required 5 year of clinical… more
- Highmark Health (Harrisburg, PA)
- …Certified Professional Medical Auditor (CPMA) + 5 years with hospital or physician coding and/or auditing, as well as, education techniques and methods. ... OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality… more
- Cognizant (Harrisburg, PA)
- **About the role** As an Inpatient Medical Coding Auditor , you will make an impact by auditing consultant inpatient. You will be a valued member of the Cognizant ... Review ICD-10 inpatient patient records for accuracy and compliance + Review physician documentation to verify diagnosis and procedures + Communicate with physicians… more
- CVS Health (Harrisburg, PA)
- …, and/or auditing. + CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist- Physician ) required. + CRC (Certified Risk Adjustment Coder) + ... regulations and internal policies and procedures. + Proven ability to support coding judgment and decisions using industry standard evidence and tools. + Proficient… more
- Intermountain Health (Harrisburg, PA)
- …maintains accurate records to document costs and benefits. Facilitates and enhances the coding and diagnosis-related group between physician and coding ... **Job Description:** The goal of the Clinical Documentation Specialist- Auditor is to improve the accuracy of the overall clinical picture and the representation of… more
- UPMC (Pittsburgh, PA)
- **Join UPMC Corporate Finance as a Compliance Auditor , Associate!** Are you detail-oriented and passionate about ensuring compliance in healthcare? **UPMC Corporate ... Finance** is looking for a dedicated and meticulous **Compliance Auditor , Associate** to join our team. This role is...role is crucial in maintaining the integrity of our coding and billing processes, ensuring they meet state and… more
- UPMC (Pittsburgh, PA)
- UPMC Health Plan has an exciting opportunity for a Risk Adjustment Clinical Auditor /Analyst position in the Medicare department. This is a full time position working ... daylight hours and will be fully remote.. The Clinical Auditor /Analyst is an integral part of the Risk Adjustment...are supported within the audit year, and utilize AHA Coding clinics, ICD-10-CM Coding Guidelines, CPT … more
- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The Network Provider Services Auditor performs audits as part of the Documentation and Coding Compliance Program ... professional services billed by providers employed with St. Luke's Physician Group (SLPG). In doing so, works with providers...providers and their office staff, as well as the Coding and SLPG Billing Department. JOB DUTIES AND RESPONSIBILITIES:… more
- St. Luke's University Health Network (Allentown, PA)
- …The appeals process may include collaboration with the Claim Editing Manager, Physician , Specialty Coder, AR specialist or Auditor /Educator. Demonstrate the ... to pay for health care. The Claim and Denial Coding Analyst role is a Certified Medical Coder who...clean claim submission and timely review and resolution of coding related claim denials for professional services, FQHC, MSO,… more
- CVS Health (PA)
- …5 years for CPC. + CPC (Certified Professional Coder) **or** CCS-P (Certified Coding Specialist- Physician ) and CRC (Certified Risk Adjustment Coder) required. + ... highlighting findings, recommendations, and areas of concern to be delivered to coding resources. + Adhere to stringent timelines consistent with project deadlines… more