• Audit & Reimbursement II

    Elevance Health (Harrisburg, PA)
    ** Audit & Reimbursement II ** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... Medicare and Medicaid Services to transform federal health programs. The ** Audit and Reimbursement II ** will support our Medicare Administrative Contract… more
    Elevance Health (10/09/25)
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  • Business Resiliency Manager II

    PNC (Pittsburgh, PA)
    …to contribute to the company's success. As a Business Resiliency Manager II within PNC's Business Resiliency organization, you will be based in Pittsburgh, ... may be performed remotely, at manager's discretion. The Business Resiliency Manager II will oversee a team of Resilience Professionals responsible for the Business… more
    PNC (09/25/25)
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  • DRG Specialist II

    UPMC (Pittsburgh, PA)
    UPMC Corporate Revenue Cycle is hiring a DRG Specialist II to join our coding team! This opportunity works Monday through Friday during daylight hours. The position ... will be fully remote! In this role, the DRG Specialist II will review clinical documentation within the medical record to ensure that all patient resource… more
    UPMC (09/25/25)
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  • Testing and Monitoring Analyst II (Invest)

    Ally (Harrisburg, PA)
    …your opportunities be, too? **The Opportunity** The Testing and Monitoring Analyst II for Invest operates independently and is responsible for conducting in depth ... risk within a specific area, training needs and control deficiencies. The Analyst II is responsible for documenting and reporting results of the reviews in a… more
    Ally (10/04/25)
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  • Business Continuity Manager II

    PNC (Pittsburgh, PA)
    …opportunity to contribute to the company's success. As a Business Continuity Manager II within PNC's Technology organization, you will be based in Pittsburgh, PA, ... aspect of business continuity. Partners with the business in relationships with audit and government regulators on business continuity issues. + Leads a functional… more
    PNC (09/04/25)
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  • Insurance Specialist II - Corporate Patient…

    Guthrie (Sayre, PA)
    …develop and train internal rejection protocols. Keeps current with coding knowledge, reimbursement policies, payer guidelines and other sources in order to ensure ... best practice procedures are followed. 5. Ensures staff adherence of protocols by audit and education. 6. Identifies and promptly reports payer, system or billing… more
    Guthrie (09/11/25)
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  • Claims Liaison II

    Centene Corporation (Harrisburg, PA)
    …changes and updates and submit change requests (CRs) to update payment system + Audit check run and send claims to the claims department for corrections + Identify ... a managed care environment. Knowledge of provider contracts and reimbursement interpretation preferred. **License/Certification:** CPC certification preferred. Pay Range:… more
    Centene Corporation (09/05/25)
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  • Site Medical Director II

    YesCare Corp (Philadelphia, PA)
    …expertise. **Key Responsibilities** + **Administrative Duties:** + Chair the Medical Audit Committee, ensuring quality standards are upheld. + Consult with community ... Discount and Rewards Program + Tuition Assistance + Continuing Education Reimbursement **Why Join YesCare?** YesCare provides a supportive and structured environment… more
    YesCare Corp (10/03/25)
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  • Coding Auditor Educator-Inpatient

    Highmark Health (Harrisburg, PA)
    …OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and ... coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure… more
    Highmark Health (09/20/25)
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  • Certified Coding Specialist - Profee

    UPMC (Pittsburgh, PA)
    …accuracy in code and charge selection, support internal and external audit reviews-including RAC-related audits-and approve account adjustments as appropriate. We're ... to accurately complete the coding process. + Investigate and resolve reimbursement issues, including denials, in a timely manner and demonstrate proficiency… more
    UPMC (10/08/25)
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