• Analyst, Coding Data Quality…

    CVS Health (PA)
    …all with heart, each and every day. **Position Summary** Responsible for performing quality inter-rater review audits of medical records coded by internal team (CDQA ... to demonstrate proficiency in the following: + Proven ability to support coding judgment and decisions using industry standard evidence and tools. + Ability… more
    CVS Health (10/02/25)
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  • Coding Data Quality…

    CVS Health (Harrisburg, PA)
    …regulations and internal policies and procedures. + Proven ability to support coding judgment and decisions using industry standard evidence and tools. + Proficient ... providers in the office and/or facility setting. + Sound knowledge of coding guidelines and regulations to meet compliance requirements, such as establishing medical… more
    CVS Health (09/27/25)
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  • Inpatient Medical Coding Auditor

    Humana (Harrisburg, PA)
    …of our caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and ... (eg, ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex...to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where… more
    Humana (09/24/25)
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  • Coding Auditor Educator-Inpatient

    Highmark Health (Harrisburg, PA)
    …and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding , billing and documentation ... and disease processes as it relates to the DRG/APC and other clinical data quality management factors. With technical direction and assistance from management,… more
    Highmark Health (09/20/25)
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  • Auditor , HCC Risk Adjustment Coding…

    Datavant (Harrisburg, PA)
    Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data ... platform is powered by the largest, most diverse health data network in the US, enabling data ...to realize our bold vision for healthcare. As an Auditor , HCC Risk Adjustment Coder, you will review medical… more
    Datavant (08/08/25)
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  • Compliance Auditor , Intermediate (Cemc,…

    UPMC (Pittsburgh, PA)
    …and HCPCS codes to ensure consistency and efficiency in claims processing, data collection, and quality reporting. . **Regulatory Compliance:** Conduct audits ... **Join UPMC Corporate Compliance as an Intermediate Compliance Auditor !** Are you passionate about ensuring accuracy and compliance in healthcare documentation and… more
    UPMC (09/04/25)
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  • Risk Adjustment Clinical Auditor /Analyst

    UPMC (Pittsburgh, PA)
    UPMC Health Plan has an exciting opportunity for a Risk Adjustment Clinical Auditor /Analyst position in the Medicare department. This is a full time position working ... daylight hours and will be fully remote.. The Clinical Auditor /Analyst is an integral part of the Risk Adjustment...are supported within the audit year, and utilize AHA Coding clinics, ICD-10-CM Coding Guidelines, CPT … more
    UPMC (09/30/25)
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  • Compliance Auditor , Associate

    UPMC (Pittsburgh, PA)
    …assignment appropriateness to ensure consistency and efficiency in claims processing, data collection, and quality reporting. + **Post-Audit Training:** Conduct ... **Join UPMC Corporate Finance as a Compliance Auditor , Associate!** Are you detail-oriented and passionate about...role is crucial in maintaining the integrity of our coding and billing processes, ensuring they meet state and… more
    UPMC (07/24/25)
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  • Provider Services Auditor

    St. Luke's University Health Network (Allentown, PA)
    …of a patient's ability to pay for health care. The Network Provider Services Auditor performs audits as part of the Documentation and Coding Compliance Program ... In doing so, works with providers and their office staff, as well as the Coding and SLPG Billing Department. JOB DUTIES AND RESPONSIBILITIES: + Perform quality … more
    St. Luke's University Health Network (09/04/25)
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  • Physician Advisory Services Auditor

    Intermountain Health (Harrisburg, PA)
    **Job Description:** The goal of the Clinical Documentation Specialist- Auditor is to improve the accuracy of the overall clinical picture and the representation of ... illness of patients through improved clinical documentation and diagnostic coding practices. Job Essentials Reviews medical records documentation for reimbursement,… more
    Intermountain Health (10/01/25)
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