• Utilization Management

    Penn Medicine (Lancaster, PA)
    …you living your life's work? Summary: + Position Summary: The Utilization Management Specialist - Denials is responsible for evaluating medical records ... insurance benefit structures and related legal medical issues. + Knowledge of utilization management and quality improvement processes. + Experience working… more
    Penn Medicine (05/01/25)
    - Related Jobs
  • Denials Management Specialist

    St. Luke's University Health Network (Allentown, PA)
    …communities we serve, regardless of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party ... JOB DUTIES AND RESPONSIBILITIES: + Reviews all Inpatient Retroactive Denials in the Denials Management ...+ Prefer minimum of 2-5 years' experience in case management and/or utilization management . +… more
    St. Luke's University Health Network (05/14/25)
    - Related Jobs
  • DRG Specialist

    UPMC (Pittsburgh, PA)
    UPMC Corporate Revenue Cycle is hiring a DRG Specialist to work on inpatient auditing within our Coding Department. This position will be a work-from-home position ... documentation within the medical record to ensure that all patient resource utilization , principal diagnosis, secondary diagnoses, and PCS procedures have been coded… more
    UPMC (05/21/25)
    - Related Jobs
  • Authorization Specialist Associate

    Geisinger (Danville, PA)
    …Duties + Acts as coordinator between all Revenue Cycle teams and departments, Utilization Management and Care Management , Providers, various departments, ... ensure completion on all peer to peer review and denials . Acts as a liaison for all financial matters...and domestic partners. Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration,… more
    Geisinger (05/31/25)
    - Related Jobs