- Highmark Health (Harrisburg, PA)
- …OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality ... and accuracy of coding , billing and documentation related to DRGs, APCs, CPTs...Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or physician… more
- Humana (Harrisburg, PA)
- …caring community and help us put health first** The Senior Inpatient Medical Coding Professional extracts clinical information from a variety of medical records and ... evaluation of variable factors. **Responsibilities** The Senior Inpatient Medical Coding Professional confirms appropriate diagnosis related group (DRG) assignments.… more
- Humana (Harrisburg, PA)
- …years of healthcare experience in revenue cycle management (related to billing, coding , collections for Medicare and Medicaid claims) + Experience with Auditing and ... monitoring of healthcare records + Must be able to work core business hours on EST time between (9am-5pm). + Willingness to travel up to 10% to conduct audits at site locations. + Ability to manage multiple or competing priorities and meet deadlines + Must be… more
- Humana (Harrisburg, PA)
- …This is a full-time, remote/work-from-home position. **Description** The Inpatient Medical Coding Auditor extracts clinical information from medical records and ... Quality Team is looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for proper reimbursement,… more
- UPMC (Pittsburgh, PA)
- **Join UPMC Corporate Compliance as an Intermediate Compliance Auditor !** Are you passionate about ensuring accuracy and compliance in healthcare documentation and ... **UPMC Corporate Compliance** is seeking a dedicated and detail-oriented **Intermediate Compliance Auditor ** to join our team! This position will be based out 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
- St. Luke's University Health Network (Allentown, PA)
- …regardless of a patient's ability to pay for health care. The Provider Services Auditor & Educator is a certified medical coder who serves as a primary resource ... ( auditor and educator) to assigned St. Luke's Providers, Leadership,...and Support Staff, Coders, and Billing Staff around professional coding and compliance. The Coding and Compliance… more
- St. Luke's University Health Network (Allentown, PA)
- …+ Participate in Administrative Law Judge (ALJ) hearings and/or formal meetings with auditor or payor representatives in defense of coding appeals, as needed. ... Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all diagnosis and procedure codes to assure properly assigned… more
- Penn State Health (Hershey, PA)
- …supervise, and perform medical record audits of electronic and manual documentation, coding , and billing for technical and professional services. + Develop formal ... + Minimum ten (10) years experience in comprehensive compliance, audit, billing, coding , and documentation experience, preferably in complex health care system. +… more
- Penn State Health (Hershey, PA)
- …+ Minimum ten (10) years experience in comprehensive compliance, audit, billing, coding , and documentation experience, preferably in complex health care system. + ... in developing strong, collaborative teams. **PREFERRED QUALIFICATION(S):** + Advanced degree + Coding certification (eg, CCS, CPC, RHIA, RHIT) + Certified Internal … more