• Claim Audit Quality

    CVS Health (Harrisburg, PA)
    …each and every day. **Position Summary** The Quality Specialist will audit pre and post payment claims for accuracy and eligibility transactions. They ... identifying errors, necessary corrective measures, and may participate in special audit assignments. **Required Qualifications** + 1+ years of experience working in… more
    CVS Health (10/16/25)
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  • Ambulatory Coding and Doc Specialist

    Penn Medicine (Bala Cynwyd, PA)
    …and timely claim submission. . Review secured authorizations and pre-billed claims as needed to ensure they adequately reflect the procedures preformed . In ... Monument Road** **Hours: Full-Time** **Job Summary:** The Ambulatory Coding and Documentation Specialist reports to the Primary Care Service Line, Director of … more
    Penn Medicine (08/07/25)
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  • Digital Media Specialist /Videographer…

    Philadelphia Insurance Companies (Bala Cynwyd, PA)
    …them to achieve their goals. Our talented team delivers actuarial, audit , corporate communications, financial and investment, human capital services, information ... to our customers. Job Summary We're seeking a talented Digital Media Specialist to create compelling digital content for local, national and global audiences.… more
    Philadelphia Insurance Companies (09/06/25)
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  • Facility Coding Inpatient DRG Coding…

    Banner Health (PA)
    …coding expertise to resolve issues and support appropriate reimbursement. Proficiency in claims software to address coding edits and claim denials utilizing ... to work and receive care. In this **Inpatient Facility/HIMS Certified Medical Coder, Quality Associate** position, you bring your **5 years of acute care inpatient… more
    Banner Health (10/16/25)
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  • Compliance Auditor, Associate

    UPMC (Pittsburgh, PA)
    …ensure consistency and efficiency in claims processing, data collection, and quality reporting. + **Post- Audit Training:** Conduct post- audit compliance ... training sessions for physicians and non-physician practitioners based on audit results. These sessions will provide education specific to the issues found during… more
    UPMC (07/24/25)
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  • Compliance Auditor, Intermediate (Cemc, CPC,…

    UPMC (Pittsburgh, PA)
    …ICD-10-CM, CPT, and HCPCS codes to ensure consistency and efficiency in claims processing, data collection, and quality reporting. . **Regulatory Compliance:** ... laws, regulations, and policies. . **Reporting:** Prepare written reports of audit results, including recommendations for improvement and compliance with state and… more
    UPMC (10/10/25)
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