• Clinical Appeals Reviewer

    AmeriHealth Caritas (Philadelphia, PA)
    …process, preferably within a managed care organization **Licensure:** + Current and unrestricted Registered Nurse ( RN ) licensure or compact state licensure ... + Process appeals, ensuring compliance with all regulatory milestones + Review medical records to identify Hospital-Acquired Conditions (HAC), ensure proper… more
    AmeriHealth Caritas (10/13/25)
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  • Medical Records Technician CDIS (Outpatient)

    Veterans Affairs, Veterans Health Administration (Lebanon, PA)
    …years of experience in clinical documentation improvement; OR - Clinical experience, such as Registered Nurse ( RN ), Medical Doctor (MD), or Doctor of ... encounters through retrospective, ideally prior to coding and billing, review of outpatient encounters and extensive provider education. Apply comprehensive… more
    Veterans Affairs, Veterans Health Administration (11/21/25)
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  • Administrator on Duty - Williamsport- Full-Time-…

    UPMC (Williamsport, PA)
    …of hire ACLS preferred + Basic Life Support (BLS) OR Cardiopulmonary Resuscitation (CPR) + Registered Nurse ( RN ) *Current licensure either in the state where ... **Licensure, Certifications, and Clearances:** Current Pennsylvania licensure as a Registered Professional Nurse . National Certification preferred. National… more
    UPMC (11/11/25)
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  • Clinical Referral Specialist, Neuroscience Admin,…

    Penn Medicine (Lancaster, PA)
    …QUALIFICATIONS:** + Current licensure as a Licensed Practical Nurse (LPN) (or as a Registered Nurse ( RN )), issued by the PA State Board of Nursing issued ... orders to facilitate the intake process. + Uses clinical assessment skills to review referrals and identify additional care needs or a more appropriate care setting.… more
    Penn Medicine (11/11/25)
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  • Ambulatory Certified Coding Specialist / Clinical…

    Trinity Health (Newtown Square, PA)
    …Nursing (BSN, AS or Diploma), or an Advanced degree in Medical Field + If RN , Current Registered Nurse License + Certified Coding Specialist (CCS), Certified ... accuracy, and integrity of medical record documentation through extensive record review . Through interaction with physicians and other members of the healthcare… more
    Trinity Health (11/14/25)
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  • Clinical Resource Coordinator - Full Time Day…

    Penn Medicine (Philadelphia, PA)
    …assignment (Outlook, Canopy, CERME, ECIN, shared drive, Internet) Credentials: + Registered Nurse - PA (Required) + PA RN Licensure required. Education or ... care settings and timely patient flow; elevates issues appropriatelyEnters all review activity in Canopy concurrentlyAccounts for all patient days accurately in… more
    Penn Medicine (11/07/25)
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  • Advanced Practice Provider - Physician Assistant…

    EGA Associates (Pottsville, PA)
    …purposes and in accordance with their need and learning capacity.Assists the Registered Nurse to ensure all patient information on electronic encounter ... **Job Description** EGA Associates, LLC. is currently seeking a Nurse Practitioner (NP) or Physician Assistant (PA) to provide...a training program which is accredited by the Accreditation Review Commission on Education of PA (ARC-PA) or one… more
    EGA Associates (09/16/25)
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  • Clinician - Epilepsy Monitoring Unit (UPMC…

    UPMC (Pittsburgh, PA)
    …sign-on bonus available for nurses with over 1 year of experience Are you a Registered Nurse passionate about delivering the best care possible and want to make ... Licensure, Certifications, and Clearances: + Current Pennsylvania licensure as a Registered Professional Nurse . + National Certification preferred. + CPR… more
    UPMC (11/25/25)
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  • Infection Control Coordinator - Gracedale Nursing…

    County of Northampton (Nazareth, PA)
    …patient care regulatory requirements for documentation; AND Possession of licensure as a Registered Nurse issued by the Commonwealth of Pennsylvania; AND Must ... and objectives are still met, and submits plan for review to higher level nursing and administrative staff, then...02 Do you have a current and valid Pennsylvania RN license? + Yes + No 03 Do you… more
    County of Northampton (11/25/25)
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  • Payment Integrity Clinician

    Highmark Health (Harrisburg, PA)
    …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... and the proper action to complete the retrospective claim review with the goal of proper and timely payment...Payment Integrity strategies on a pre-payment and retrospective claims review basis. Review process includes a … more
    Highmark Health (11/14/25)
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