April 30, 2026For U.S. Positions: While subject to change based on business needs, Leidos reasonably anticipates that this job requisition will remain open for at least 3 days with an anticipated close date of no earlier than 3 days after the original posting date as listed above. If you received an email purporting to be from Leidos that asks for payment-related information or any other personal information (e.g., about you or your previous employer), and you are concerned about its legitimacy, please make us aware immediately by emailing us at LeidosCareersFraud@leidos.com.
Healthcare (professional) billing, knowledge of CPT/ICD-10 coding, government, government sponsored and commercial follow-up requirements as well as appeals processes and requirements Thorough understanding of the revenue cycle and how the various components work together Perform ongoing review and feedback on the correct use of CPT-4 and ICD-10 codes and to ensure adherence to established Government and third-party billing guidelines, AMA, AAP, CMS, and coding policies. Prepares well thought-out and meaningful performance appraisals for direct reports summarizing performance as well as focusing on opportunities for improvement and recognizing performance that exceeds expectations AAPC CPC Certification required Mainframe billing software (e.g., Cerner, Epic, IDX) experience highly desirable As an IPM employee you will be part of a first-class organization offering: A Challenging and rewarding work environment.
p>Assigns and properly sequences accurate ICD-10-CM diagnosis and ICD-10-PCS procedure codes in accordance with Official Coding Guidelines, UHDDS definitions, Coding Clinic guidance and CMS to a full range of inpatient services including cases with a high complexity level. Ensures accurate capture of Major Comorbid Conditions (MCC)/Comorbid Conditions (CC), Present on Admission (POA) indicators, Hospital-Acquired Conditions (HACs), Patient Safety Indicators (PSIs), Severity of Illness (SOI) and Risk of Mortality (ROM).
p>Assigns and properly sequences accurate ICD-10-CM diagnosis and ICD-10-PCS procedure codes in accordance with Official Coding Guidelines, UHDDS definitions, Coding Clinic guidance and CMS to a full range of inpatient services including cases with a high complexity level. Ensures accurate capture of Major Comorbid Conditions (MCC)/Comorbid Conditions (CC), Present on Admission (POA) indicators, Hospital-Acquired Conditions (HACs), Patient Safety Indicators (PSIs), Severity of Illness (SOI) and Risk of Mortality (ROM).
p>Hospital Coder Inpatient Senior Coder is an expert-level coding professional responsible for accurately reviewing and coding complex inpatient medical records using ICD-10-CM diagnosis codes, ICD-10-PCS procedure codes, and appropriate MS-DRG/APR-DRG grouping methodologies. This role serves as a subject matter expert within the coding department, performing second level reviews, mentoring staff, and collaboration with Clinical Documentation Improvement (CDI), quality, and revenue cycle teams to ensure optimal reimbursement and compliance with regulatory guidelines.
Pennington, NJ25 days ago
Effectively and continuously communicates information to HIM leadership and other CH leadership and departments on status of Physician Queries, Operative reports, ER Notes, Pathology reports and other pertinent documents to assist in management of DNFB and timeliness of overall HIM operations. Frequent physical demands include: Occasional physical demands include: Standing , Walking , Climbing (e.g., stairs or ladders) , Carry objects , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl.
Philadelphia, PA18 days ago
p>Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Act as a Coding Quality Specialist by referring charts that require clarification of vague or unclear documentation for accurate coding to the physician for the needed documentation.
Philadelphia, PA30+ days ago
p>Loading job Back to Search Results Previous Opportunity Next Opportunity Current UPHS employees must apply HERE HIM Inpatient Coding Specialist III Job ID: 303888 Category: Health Information Management/Coding Work Type: FT Location: Philadelphia, PA, United States Work Schedule: M-F, 8 hr days, hybrid Share: Apply Now Save Job Saved Description Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. • Promptly and accurately assigns Coding Hold reasons to all records that cannot be completed immediately due to: - Missing Operative Notes - Missing Pathology Report - Physician Query Needed - Death Review - Discharge Disposition - Missing Other Reports (Card Cath, EPS, etc) • Is willing to adjust schedule to complete workload and meet pivotal revenue cycle deadlines when requested by management.
Frequent physical demands include: Occasional physical demands include: Standing , Walking , Climbing (e.g., stairs or ladders) , Carry objects , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl , Wrist position deviation , Pinching/fine motor activities , Keyboard use/repetitive motion , Taste or Smell , Talk or Hear. Assists manager with ongoing monitoring and education process by assuming responsibility for coordination and scheduling, as well as research, design and delivery of large group education sessions to ensure accurate and compliant physician documentation and coding.
li>Provide customer service/education and act as a resource to Medicare Certified Offices with regards to CMS guidelines, Home Care Coding, PDGM guidelines and billing related issues. Responsibilities:
- Review clinical information for appropriateness, congruency, and accuracy as it relates to the OASIS and ICD 10 coding while using the Medicare PDGM billing model and CMS guidelines.
li>Provide customer service/education and act as a resource to Medicare Certified Offices with regards to CMS guidelines, Home Care Coding, PDGM guidelines and billing related issues. Active State RN Nursing License, Physical (PT), Occupational (OT) or Speech (SLP) Therapists with required certifications with a minimum of 2 years clinical experience.
Bala Cynwyd, PA30+ days ago
p>Loading job Back to Search Results Previous Opportunity Next Opportunity Current UPHS employees must apply HERE HIM Inpatient Coding Spec II Job ID: 304173 Category: Health Information Management/Coding Work Type: FT Location: Bala Cynwyd, PA, United States Work Schedule: M-F, 8 hr day shift, remote Share: Apply Now Save Job Saved Description Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. • Promptly and accurately assigns Coding Hold reasons to all records that cannot be completed immediately due to: • Missing Operative Notes • Missing Pathology Report • Physician Query Needed • Mortality Review • Discharge Disposition • Missing Other Reports (Card Cath, EPS, etc) • Is willing to adjust schedule to complete workload and meet pivotal revenue cycle deadlines when requested by management.
p>Provides direct supervision, support, education and direction to physician fee coding staff as it relates to time management, delegation of workflow tasks and responsibilities, knowledge of industry guidelines, laws and regulations. Proactively troubleshoots documentation and/or communication issues and communicates directly with members of CHMG to provide feedback and education to accurately capture required documentation to support revenue integrity.
Interpretation and application of building codes (IBC, local/state/provincial codes). Impact: Help organizations reduce risk, avoid penalties, and operate safely and legally.
The contractor employee shall have experience in performing various quality assurance functions such as Quality Planning, Inspection and Testing, Auditing, review of Objective Quality Evidence, and Quality Management, and/or services that are essential to the safe operations of United States (U.S.) Submarines and Naval Level I Material Program. The QMS team facilitates and participates in Critiques and trouble reports, conducts audits, surveillances and self-assessments, inputs, tracks and evaluates command quality commitments, maintains Quality Management System (QMS) and website repositories.
li>Managing development teams in building healthcare AI and GenAI solutions, including analytical modeling, prompt engineering, Python-based development, testing, communication of results to clinical and operational stakeholders, front-end and back-end integration, and iterative use case development with health system clients;
Documenting and analyzing healthcare business processes - across clinical operations, and population health programs - to identify AI and GenAI opportunities, gather requirements, define initial hypotheses, and develop solution approaches tailored to health system workflows;
Collaborating with health system client teams - including clinical informatics, population health, and IT leaders - to understand their business and clinical problems and select the appropriate models, LLMs, and approaches for AI/GenAI use cases;
Designing and solutioning AI/GenAI architectures for health system clients, including RAG-based clinical knowledge retrieval systems, agentic AI workflows for care management and revenue cycle automation, and custom LLM application builds with appropriate PHI safeguards;
Managing teams to process healthcare unstructured and structured data - including clinical notes, discharge summaries, claims records, EHR data, and ADT feeds - for use as LLM context, including embedding of large clinical text corpora, generative SQL query development, and building connectors to EHR back-end databases;
Managing daily operations of a global healthcare data science team on client engagements, reviewing developed models, providing feedback, and assisting in analysis of clinical and operational outcomes;
Directing data engineers and other data scientists to deliver efficient, HIPAA-compliant solutions that meet health system client requirements for clinical, financial, and operational AI use cases;
Leading and contributing to development of proof of concepts, pilots, and production use cases for health system clients - spanning clinical decision support, prior authorization automation, patient risk scoring, workforce optimization, and throughput modeling - while working in cross-functional teams;
Facilitating and conducting executive-level presentations to health system leadership showcasing GenAI and ML solution capabilities, use case development progress, model performance, and recommended next steps;
Structuring, writing, communicating, and facilitating client presentations that translate complex AI and ML concepts into clear clinical and business value narratives for health system audiences; and,
Managing associates and senior associates through coaching, providing feedback, and guiding work performance, with an emphasis on developing healthcare domain knowledge alongside technical AI and ML capabilities. You will architect and build production-grade RAG pipelines, MCP connections, agentic AI workflows, and MLOps frameworks, managing daily operations across global delivery teams while engaging health system leaders at the executive level to ensure measurable clinical and operational impact.
Wilmington, DE23 days ago
PRIMARY FUNCTION: The Manager, Physician Revenue Integrity is responsible for operational management, stabilization, and optimization of Professional Billing (PB) locations as it relates to the professional fee schedule, Epic Charge Generation Tracker (CGT), payer billing rules/regulations, denial prevention, charge capture, and charge reconciliation for all billable professional services. The Manager, Physician Revenue Integrity acts as the primary contact for providers, clinical, and administrative staff to answer coding questions related to evaluation and management services, office-based procedures, and bedside procedures and initiates research related to revenue enhancement and correct coding for Epic PB clinical charge capture.
Mgr - MM PHS Bio-Medical Services
Mgr - MMBristol, Pennsylvania30+ days ago
Overview: Join our team of dedicated professionals who provide services and operational support to award winning hospitals through roles in supply chain, IT and cybersecurity, clinical engineering, capital procurement, medical coding, project management and more. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.
PwC does not intend to hire experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth within the following policy: https://pwc.to/H-1B-Lottery-Policy. At PwC, our people in software and product innovation focus on developing cutting-edge software solutions and driving product innovation to meet the evolving needs of clients.
p>Clinical ›Corporate and business operations ›Customer and support services ›Early careers›Sales and account management ›Technology and data›Physicians›Advanced practice clinicians›Pharmacy›Behavioral health›Nursing›Medical coding›Clinical support›U.S. Artificial intelligence Architecture Business systems analysis Data analytics Data engineering Data science Network infrastructure Product management & development Security and risk Software engineering.
The Area HEMA Manager works independently, supporting the reimbursement and market access development to improve access for patients, providers, and payors to the organization's technology and product portfolio, as well as the primary expert in the field in all areas related to reimbursement of the company's products. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information.
Preferred field(s) of study: Computer Engineering, Computer Applications, Computer Programming, Computer Science, Cybersecurity, Information Security, Information Technology, or Management Information Systems • Leading development of cloud security strategies • Designing scalable security processes and governance • Strategizing automated enforcement mechanisms for cloud security • Configuring custom policy frameworks within CNAPP technologies • Instrumenting in-line security scanning technologies • Providing guidance on secure coding and cloud security • Proficiency in scripting and programming languages • Kubernetes and container orchestration platform administration experience. Examples of the skills, knowledge, and experiences you need to lead and deliver value at this level include but are not limited to: • Analyse and identify the linkages and interactions between the component parts of an entire system.
ul>At least a Bachelors degree or, in lieu of a degree, demonstrating in addition to the minimum years of experience required for the role, three years of specialized training and/or progressively responsible work experience in Engineering Program Management for each missing year of college is required. In this capacity, you will help lead and coordinate end-to-end execution of technology initiatives - driving disciplined project planning, proactive stakeholder communication, and consistent service delivery across cross-functional engineering teams.
li>Occasional physical demands include: Sitting , Climbing (e.g., stairs or ladders) , Carry objects , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl , Keyboard use/repetitive motion. Knowledge of insurance (ICD-9/10 coding, CMS regulations, state/federal regulations, CLIA, DOH, OSHA regulations) preferred; Solid knowledge of and experience in billing and health insurance guidelines and practices, including commercial, CMS and managed care payers.
Knowledge of insurance (ICD-9/10 coding, CMS regulations, state/federal regulations, CLIA, DOH, OSHA regulations) preferred; Solid knowledge of and experience in billing and health insurance guidelines and practices, including commercial, CMS and managed care payers. When determining base salary and/or rate, several factors may be considered including, but not limited to location, years of relevant experience, education, credentials, negotiated contracts, budget, market data, and internal equity.
Pennington, NJ30+ days ago
li>Occasional physical demands include: Sitting , Climbing (e.g., stairs or ladders) , Carry objects , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl , Keyboard use/repetitive motion. Knowledge of insurance (ICD-9/10 coding, CMS regulations, state/federal regulations, CLIA, DOH, OSHA regulations) preferred; Solid knowledge of and experience in billing and health insurance guidelines and practices, including commercial, CMS and managed care payers.
p>Frequent physical demands include: Occasional physical demands include: Standing , Walking , Climbing (e.g., stairs or ladders) , Carry objects , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl. When determining base salary and/or rate, several factors may be considered including, but not limited to location, years of relevant experience, education, credentials, negotiated contracts, budget, market data, and internal equity.
KING OF PRUSSIA, PA4 days ago
AI & Data-Driven Solution Design Apply data literacy and AI fluencyto: Ask the right questions of data and models Define meaningful metrics Interpret outputs at a decision-making level Understand AI capabilities, limitations, and risks to appropriately scope use cases. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 40 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom.
KING OF PRUSSIA, PA4 days ago
AI & Data-Driven Solution Design Apply data literacy and AI fluencyto: Ask the right questions of data and models Define meaningful metrics Interpret outputs at a decision-making level Understand AI capabilities, limitations, and risks to appropriately scope use cases. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 40 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom.
p>PwC does not intend to hire experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth within the following policy: https://pwc.to/H-1B-Lottery-Policy. At PwC, we recognize that conviction records may have a direct, adverse, and negative relationship to responsibilities such as accessing sensitive company or customer information, handling proprietary assets, or collaborating closely with team members.
Philadelphia, PA9 days ago
Our purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities. Leverage industry knowledge, market insights, trends, and proven approaches to help clients confirm priorities and develop strategies that drive measurable value to the business and customer experience.
PwC does not intend to hire experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth within the following policy: https://pwc.to/H-1B-Lottery-Policy. Examples of the skills, knowledge, and experiences you need to lead and deliver value at this level include but are not limited to:
• Craft and convey clear, impactful and engaging messages that tell a holistic story.
King of Prussia, PA30+ days ago
Responsibilities: • Leads or plays a key role in cross-functional teams for the review of safety data or safety-related reports • Mentors and trains newer members of the functional area • Ensures functions to comply with national and international regulations, such as GxP guidelines and/or any other relevant international and national legislation(s), regulations(s), and guidance(s) as well as company policies and procedures in area of responsibility • Ensures direct reports to support and ensure QPPV's oversight on the company's Pharmacovigilance system, and identify, implement and monitor KPIs/KQIs across the company and manages cross functional CAPAs and other improvement activities on behalf of the QPPV. • Participate in ICSR reporting compliance analysis and respective CAPA • Together with Risk Management function develops and maintains Medical Concepts to support internal decision making and safety analyses for safety surveillance and provides expertise to pharmacovigilance and clinical development programs with regards to safety data/ SAE coding • Manages regular MedDRA upgrades and provides impact analysis to RM physicians and ME • Develop and provide advanced analytical outputs to global teams to support analyses and decision making based on safety data.
Philadelphia, PA6 days ago
p>More specifically, GSK Medical Analytics Insights goal is to uncover and embed findings and insights to impact the following key focus areas: Input to Innovation - informing asset strategy, evidence generation, improved clinical trial design, lifecycle planning, and emerging scientific opportunity identification.
5+ years' experience, including 3+ years in healthcare, applying analytics and insights to inform business or medical decisions through market research, analytics, forecasting, customer insights, evidence generation or related disciplines; or 3+ years with an advanced degree, including 2+ years in healthcare.
Experience and strong subject matter expertise in financial systems and management practices of healthcare providers (physicians, medical directors, HCPs) in a variety of settings (hospitals, hospital outpatient clinics, ASC's, ACO's, wound care clinics, and physician offices). + Execute regional payer strategies , including expanding and optimizing commercial coverage for priority technologies, engaging payer decision-makers, and aligning access initiatives with enterprise market access objectives to accelerate adoption and revenue growth.
Philadelphia, PA19 days ago
The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. Our purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities.
Plainsboro, NJ30+ days ago
Coordinates and as needed, facilitates serious event management processes and their outcomes, including root cause analyses (RCAs), in conjunction with the PMPH Director of Patient Safety, Quality, Regulatory and Risk and PMPH Patient Safety Officer to ensure thorough and efficient event evaluation and institutional response, including necessary internal and external reporting (New Jersey Department of Health and voluntary reporting such as The Joint Commission). Summary: The Program Manager Patient Safety reports to the PMPH Director Patient Safety, Quality Regulatory and Risk and works in partnership with both the director and the PMPH Patient Safety Officer to coordinate, monitor, and continuously improve the execution of PMPHs Patient Safety Program.