- The Cigna Group (Philadelphia, PA)
- **Job Summary:** The Medicare Coding Quality Review Audit Manager is responsible for day-to-day oversight of the Risk Adjustment coding quality ... is broadened. + Plans, develops, implements, and monitors Cigna's Medicare 's QA of coding projects. + Monitors...as designed + Works closely with Quality Review Audit Advisor to ensure Risk Adjustment coding… more
- Highmark Health (Harrisburg, PA)
- …accuracy and productivity requirements. + Assists with Regulatory Audits by performing first coding review and ranking of charts. Build partnerships and work ... not limited to Hierarchical Condition Category (HCC) Coding , medical coding , clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid… more
- Humana (Harrisburg, PA)
- …they need, when they need it. These efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service ... of our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure… more
- Humana (Harrisburg, PA)
- …they need, when they need it. These efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service ... part of our caring community and help us put health first** The Coding Educator 2 identifies opportunities to improve provider documentation and creates an education… more
- Banner Health (PA)
- …RHIT or RHIA Coding Certification, and make a difference!** **This is a Quality position,** not a day-to-day coding production role but does require ... Facility Coding experience. This position is task production oriented ensuring quality in the IP Facility Coding department. You have the opportunity… more
- Humana (Harrisburg, PA)
- …group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or ... daily work. The Medical Director's work includes computer based review of moderately complex to complex clinical scenarios, ...need it. These efforts are leading to a better quality of life for people with Medicare ,… more
- Humana (Harrisburg, PA)
- …group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or ... their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, ...need it. These efforts are leading to a better quality of life for people with Medicare ,… more
- Humana (Harrisburg, PA)
- …assignments. **Major Enterprise Projects that you'll be working on:** + Automated Change Quality Review + Workforce Management Demand Management + New Hire ... _Databricks Certified: Machine Learning Professional_ + 3 years of coding experience within Python/PySpark, and SparkSQL/SQL. ( **_Coding_** **_examples...need it. These efforts are leading to a better quality of life for people with Medicare ,… more
- Cardinal Health (Harrisburg, PA)
- …preferred + Demonstrate effective, empathetic and professional communication + Clear knowledge of Medicare (A, B, C, D) + 1-2 years of Pharmacy and/or Medical Claims ... billing and Coding work experience is preferred + 1-2 years of...with high volume production teams with an emphasis on quality + Able to thrive in a competitive and… more