• Senior Inpatient Medical…

    Humana (Harrisburg, PA)
    …a part of our caring community and help us put health first** The Senior Inpatient Medical Coding Professional extracts clinical information from a variety ... requires an in-depth evaluation of variable factors. **Responsibilities** The Senior Inpatient Medical Coding Professional confirms appropriate diagnosis… more
    Humana (08/02/25)
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  • Inpatient DRG Quality Auditor

    Humana (Harrisburg, PA)
    …develop educational materials. This is a full-time, remote/work-from-home position. **Description** The Inpatient Medical Coding Auditor extracts ... Coding Quality Team is looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for proper… more
    Humana (07/25/25)
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  • Coding Auditor Educator

    Highmark Health (Harrisburg, PA)
    …(Outpatient): Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or ... **GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data… more
    Highmark Health (07/16/25)
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  • Compliance Auditor , Intermediate (Cemc,…

    UPMC (Pittsburgh, PA)
    …technical school diploma is preferred. + 3 or more years of experience in medical coding , billing, auditing and compliance. + Extensive knowledge of CMS, and ... Coder (CIC) + Certified Evaluation & Management Coder (CEMC) + Certified Professional Medical Auditor (CPMA) + Certified Professional Coder (CPC) + Certified … more
    UPMC (07/11/25)
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  • Compliance Auditor , Associate

    UPMC (Pittsburgh, PA)
    …or comparable technical school diploma is preferred. + 1 year of experience in medical coding , auditing, billing and compliance. + Knowledge of CMS and ... Coder (CIC) + Certified Evaluation & Management Coder (CEMC) + Certified Professional Medical Auditor (CPMA) + Certified Professional Coder (CPC) + Certified … more
    UPMC (07/24/25)
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  • RN Clinical Review Appeals Specialist

    St. Luke's University Health Network (Allentown, PA)
    …AND EXPERIENCE: Minimum five (5) years RN/licensed provider experience in adult inpatient medical -surgical or critical care with thorough understanding of ... The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of...Administrative Law Judge (ALJ) hearings and/or formal meetings with auditor or payor representatives in defense of coding… more
    St. Luke's University Health Network (07/08/25)
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  • Director Compliance and Privacy - Investigations…

    Penn State Health (Hershey, PA)
    …and perform medical record audits of electronic and manual documentation, coding , and billing for technical and professional services. + Develop formal audit ... care including but not limited to Skilled Nursing Facilities (SNF) and inpatient rehabilitation facilities (IRF) and home health agencies (HHA). External partners… more
    Penn State Health (06/19/25)
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