- Humana (Harrisburg, PA)
- …part of our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ... guidelines are met (eg, ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor 's work assignments are varied and frequently require interpretation and independent… more
- Baylor Scott & White Health (Harrisburg, PA)
- **JOB SUMMARY** The Coding Auditor 1 is proficient in various types of coding and is responsible for performing coding quality audits and providing ... feedback to coders. The Coding Auditor 1 utilizes the International Classification of Disease (ICD-10-CM/PCS), Healthcare Common Procedure Coding System… more
- WellSpan Health (York, PA)
- Coding Auditor Location: WellSpan Health, York, PA Schedule: Full Time Schedule Full-time: 80hrs/biweekly Hours: Monday - Friday, 8am - 4:30pm Position is ... programs to employees. Duties and Responsibilities + Performs proactive or reactive coding compliance reviews as needed to identify or quantify potential issues. +… 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
- UPMC (Pittsburgh, PA)
- …help defend external coding audits when requested.** As the Senior Medical Auditor , you will provides technical expertise to review staff to ensure that all ... **UPMC is hiring a full-time Senior Medical Auditor to join their Department of Pediatrics team!...physicians, clinical, billing and coding staff are adhering to all guidelines for compliance… more
- UPMC (Pittsburgh, PA)
- **UPMC Corporate Finance is hiring a full-time Compliance Auditor , Intermediate. This position will be based out of Forbes Tower in Pittsburgh, PA. This position ... + Conduct UPMC wide auditing and monitoring to ensure coding /documentation combinations and medical record documentation adequately supports services coded… 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 Claim and Denial Coding Analyst role is a Certified Medical Coder who ensures clean claim submission and ... timely review and resolution of coding related claim denials for professional services, FQHC, MSO,...Claim Editing Manager, Physician, Specialty Coder, AR specialist or Auditor /Educator. Demonstrate the ability to formulate an appeal rationale… more
- CVS Health (Harrisburg, PA)
- …Coders (CPC). The Manager is responsible for overseeing and managing coding reviews for fraud detection, investigation, and prevention efforts to safeguard ... Stay informed about changes in the industry practices related to healthcare coding . Provide training opportunities for staff to maintain their CEUs. Assist in… more
- Dentsply Sirona (York, PA)
- …and transfer pricing. + GBS concerning GRNI reconciliations and other Medius Flow coding or research activities. + Local Accounting lead in the 1) proper ... and data requests as necessary ie Global Exposure, N&O, Internal/External auditor request, etc. + Perform reconciliations as needed. **Education:** * Bachelor's… more
- AIG (Philadelphia, PA)
- …in-depth understanding of coverages and program structures, as well as internal policy coding systems to ensure account completeness. + Designated as the first point ... prior to underwriting review; documents discrepancies and work with the premium auditor for resolution. + Performs quality control of adjustments prior to… more
- AIG (Philadelphia, PA)
- …in-depth understanding of coverages and program structures, as well as internal policy coding systems to ensure account completeness. + Designated as the first point ... prior to underwriting review; documents discrepancies and work with the premium auditor for resolution. + Performs quality control of adjustments prior to… more