- Lyric (Newtown Square, PA)
- …Clinical Manager will combine their deep knowledge of CPT, HCPCS, and ICD10CM coding guidelines with strong leadership skills to guide their team in delivering ... software. The Senior Manager's insights will shape how our clients implement our coding logic and their oversight will ensure our internal team continues to exceed… more
- Guthrie (Sayre, PA)
- Option to be Hybrid/Remote. Summary: A senior level compliance coding auditor conducting assessments in accordance with The Guthrie Clinic's policies and ... procedures and accepted guidelines for medical coding . Works closely with the Compliance Officer.... Works closely with the Compliance Officer and Compliance coding Audit Coordinator to perform audits outlined in the… more
- 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
- WellSpan Health (York, PA)
- …**Duties and Responsibilities** **Essential Functions:** + Performs proactive or reactive coding compliance reviews as needed to identify or quantify potential ... action and performs follow up reviews where necessary. + Assists with coding compliance implementation throughout the WellSpan. + Assists in the development and… more
- 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
- Geisinger (Danville, PA)
- …audits, monitoring, and provides compliance education for facility and professional documentation, coding , and billing. The Senior Compliance Auditor serves as a ... Job Summary The Senior Compliance Auditor ensures the integrity and accuracy of facility...service line area. Job Duties One of the following coding or auditing certifications are required (CCS, CPC, RHIA,… more
- Elevance Health (Seven Fields, PA)
- **Claims Auditor I, II and Senior** **Location :** This role enables associates to work virtually full-time, with the exception of required in-person training ... for employment, unless an accommodation is granted as required by law._ The **Claims Auditor I** is responsible for pre and post payment and adjudication audits of… more
- Humana (Harrisburg, PA)
- …of our caring community and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation ... and diagnosis coding for services rendered is complete, compliant and accurate...compliant and accurate to support optimal reimbursement. The Nurse Auditor 2 work assignments are varied and frequently require… more
- 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 ... doing so, works with providers and their office staff, as well as the Coding and SLPG Billing Department. JOB DUTIES AND RESPONSIBILITIES: + Perform quality audits… more
- Datavant (Harrisburg, PA)
- …will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, ... workspace! **What You Will Do:** + Performs Inpatient Facility coding audits according to scope of work, for the...of reviews, using appropriate assignment of codes and other coding -related elements using MS DRG or APR DRGs. +… more
- St. Luke's University Health Network (Allentown, PA)
- …Professional Auditor (CPMA); Certified Professional Coder (CPC); Certified); Certified Coding Specialist (CCS); In-depth knowledge of ICD CM, ICD PCS and ... serve, regardless of a patient's ability to pay for health care. The Coding Audit & Education Coordinator will be responsible for performing internal, concurrent,… more
- Datavant (Harrisburg, PA)
- …Seeking a profee auditor proficient in multi-specialty including procedure and E/M coding in multiple settings **What You Will Do:** + Performs Professional Fee ... Seeking a profee auditor proficient in multi-specialty including procedure and E/M coding in multiple settings **What You Need to Succeed:** + 5+ years of… 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
- Datavant (Harrisburg, PA)
- …will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, ... the future of healthcare from your own workspace! Inpatient auditor with 3-5 years of experience at a Trauma...strongly encouraged to apply **You Will:** + Conduct inpatient coding audits on medical records, utilizing ICD-10-CM, CPT, and… more
- Coinbase (Harrisburg, PA)
- …importance of controls, an effective control environment, and the role of Internal Auditor . * Promote new ideas / innovative means of executing projects and internal ... Google Suite or MS Excel, Word and PowerPoint. * Basic scripting experience in coding languages such as Python, Ruby, etc. *Nice to haves:* * Professional Internal… more
