• Director Risk Adjustment, Coding & Quality

    Highmark Health (Pittsburgh, PA)
    …Operational Excellence **LICENSES AND CERTIFICATIONS** **Required** + AAPC, Certified Professional Coder ( CPC ) **Preferred** + AAPC, Certified Risk Adjustment ... of ~75 employees that are health plan and community-based (embedded into provider systems ) to deliver the highest quality of care to Highmark members and improve… more
    Highmark Health (08/08/25)
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  • Medical Abstractionist

    Advatix, Inc. (Philadelphia, PA)
    …We also need you to have one or more of the followig: + Certified Professional Coder ( CPC ) or + Certified Professional Coder Apprentice + ( CPC -A) ... of inpatient data and reconciliation of billable services, including review of system processing and appropriate escalation and timely communication of errors and… more
    Advatix, Inc. (07/15/25)
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  • Analyst, Coding Data Quality Auditor

    CVS Health (Workman, MN)
    …Risk Adjustment process and Hierarchical Condition Categories (HCC) required. + CPC (Certified Professional Coder ) or CCS-P (Certified Coding ... necessity. + In depth knowledge of medical terminology and anatomy for all body systems + Understand the audit process for risk adjustment models. + Identify and… more
    CVS Health (10/02/25)
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  • Quality & Risk Adjustment Provider Consultant

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …Care Quality measures * Certified Risk Adjustment Coder (CRC via AAPC) or Certified Professional Coder ( CPC via AAPC). If you do not have both the CRC AND ... role leads face-to-face meetings with leaders in provider care systems and is responsible for developing and driving improvement...CPC , it will be required to obtain both AAPC… more
    Blue Cross and Blue Shield of Minnesota (09/30/25)
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  • Investigations Consultant

    Highmark Health (Pittsburgh, PA)
    …**Required** + None **Preferred** + Certified Fraud Examiner (CFE) + Certified Professional Coder ( CPC ) + Certified Professional Coder - Hospital( CPC -H) ... claims were adjusted correctly, resulting in expected recovery/savings. + Perform claims system extracts and create reports, graphs, and charts to timely identify… more
    Highmark Health (08/22/25)
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  • Ambulatory Coding and Doc Specialist

    Penn Medicine (Bala Cynwyd, PA)
    …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 ... assigned to support the unit, department, entity, and health system organization Qualifications: + Bachelor's Degree HIM, healthcare, or...in lieu of degree. + CCS or Certified Procedural Coder - CPC (AAPC) (Required) + RHIA,… more
    Penn Medicine (08/07/25)
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  • Compliance Auditor, Associate

    UPMC (Pittsburgh, PA)
    …coding/classification systems appropriate for inpatient /outpatient, DRG prospective payment system or office setting E/M codes. + Experience in an academic ... (CEMC) + Certified Professional Medical Auditor (CPMA) + Certified Professional Coder ( CPC ) + Certified Medical Coder (CMC) + Registered Health Information… more
    UPMC (07/24/25)
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  • Compliance Specialist

    University of Utah (Salt Lake City, UT)
    …Academy of Professional Coders ( AAPC ) recognized certification such as: Certified Professional Coder ( CPC ), Certified Professional Coder -Hospital ( ... are available on the BRR , eProposal, and eAward systems to promote compliance with this new federal policy...requirements related to regulatory and reimbursement rules, the Medicare system and proficiency with computer software such as Microsoft… more
    University of Utah (08/07/25)
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  • Certified Risk Adjustment Coding/Audit Specialist

    Redeemer Health Home Care & Hospice (Huntingdon Valley, PA)
    …another and in the services we provide. RECRUITMENT REQUIREMENTS High School Graduate. Certified coder CPC or CCS-P, and AAPC CRC certification. 2+ years coding, ... light of the Mission & Values of the Health System . Regardless of position, every job contributes to the...CPC , CRC, CCS) REQUIRED + Certified Risk Adjustment Coder - PREFERRED Knowledge + Knowledgeable of medical and… more
    Redeemer Health Home Care & Hospice (08/13/25)
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  • Internal Coding Auditor

    Dayton Children's Hospital (Dayton, OH)
    …Certified Coding Specialist - American Health Information Management Association, [Cert] CPC : Certified Professional Coder - American Academy of Professional ... audits and reviews the findings to identify areas where coder accuracy falls below the established standards. This involves...experience preferred + Previous training experience preferred Certifications + CPC , COC, CIC, CRC, CCS or CCS-P, RHIA, or… more
    Dayton Children's Hospital (09/18/25)
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