Emergency Department Medical Coder - per diem (PA/NJ) St. Luke's Health Network, Inc.Emergency Department Medical Coder - per diem (PA/NJ)Allentown, PAPart timeIndividually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care. Codes and abstracts professional fee hospital services performed by SLPG physicians from medical records according to ICD-9/ICD-10, CPT-4, HCPCS II, and CMS guidelines.
Emergency Department Coder St. Luke's Health Network, Inc.Emergency Department CoderAllentown, PAFull timeIndividually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care. Codes and abstracts professional fee hospital services performed by SLPG physicians from medical records according to ICD-9/ICD-10, CPT-4, HCPCS II, and CMS guidelines.
Professional Fee Coder (Radiology exp preferred) St. Luke's Health Network, Inc.Professional Fee Coder (Radiology exp preferred)Allentown, PAFull timeIndividually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care. Codes and abstracts professional fee hospital services performed by SLPG physicians from medical records according to ICD-9/ICD-10, CPT-4, HCPCS II, and CMS guidelines.
Per Diem Professional Fee PA/NJ Remote Coder St. Luke's Health Network, Inc.Per Diem Professional Fee PA/NJ Remote CoderAllentown, PARemotePart timeIndividually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care. Codes and abstracts professional fee hospital services performed by SLPG physicians from medical records according to ICD-9/ICD-10, CPT-4, HCPCS II, and CMS guidelines.
Professional Fee Coder(Remote PA/NJ) St. Luke's Health Network, Inc.Professional Fee Coder(Remote PA/NJ)Allentown, PARemotePart timeIndividually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care. Codes and abstracts professional fee hospital services performed by SLPG physicians from medical records according to ICD-9/ICD-10, CPT-4, HCPCS II, and CMS guidelines.
Claims and Denial Coding Analyst St. Luke's Health Network, Inc.Claims and Denial Coding AnalystAllentown, PAFull timeIndividually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless 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, and ASCs across the network.
Network Coordinator, Coding Audit & Education St. Luke's Health Network, Inc.Network Coordinator, Coding Audit & EducationAllentown, PAFull timeMust maintain and be credentialed in at least ONE of the following AHIMA and/or AAPC recognized Professional Coding Certifications: Registered Health Information Technician (RHIT); Registered Health Information Administrator (RHIA); Certified Professional Auditor (CPMA); Certified Professional Coder (CPC); Certified); Certified Coding Specialist (CCS); In-depth knowledge of ICD CM, ICD PCS and CPT/HCPCS coding systems. Reviews and validates coded medical records to assess coding accuracy, documentation integrity, compliance risk, and reimbursement impact related to ICD-10-CM/PCS, CPT/HCPCS, DRG/APC assignment, modifiers, and applicable payment methodologies.
NewEmergency Communications Operator Specialist St. Luke's Health Network, Inc.Emergency Communications Operator SpecialistAllentown, PAFull timeThe Emergency Communications Operator Specialist is responsible for all job duties of EMS Transport Dispatcher as well as reviewing non-emergency ambulance transportation requests for accuracy, proper mode of transport and complete/accurate medical necessity forms. Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care.
Emergency Department Medical Coder - per diem (PA/NJ) St. Luke's University Health NetworkEmergency Department Medical Coder - per diem (PA/NJ)Allentown, PAIndividually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care. JOB DUTIES AND RESPONSIBILITIES: Codes and abstracts professional fee hospital services performed by SLPG physicians from medical records according to ICD-9/ICD-10, CPT-4, HCPCS II, and CMS guidelines.
Medical Coder (Pennsylvania resident) GeisingerMedical Coder (Pennsylvania resident)Danville, PACarefully details review of documents such as laboratory findings, radiology reports, various scan reports, discharge summary, history and physical, consultations, orders, progress notes and other ancillary services treatment records needed to ensure all pertinent diagnoses and procedures are recorded. Coders are responsible for translating diagnostic and procedural phrases utilized by healthcare providers into coded form procedure codes that can be utilized for submitting claims to payers for reimbursement.
Coder III - Technical University of Pittsburgh Medical CenterCoder III - TechnicalPittsburgh, PARemoteMaintain daily productivity statistics and submit a weekly productivity sheet to management clearly indicating the number of hours worked, the number of coding hours, the number of average charts per hour, and number of minutes/hours spent on non-coding tasks. Completed an AHIMA or AACP-certified Coding program or certificate, Bidwell Training School or equivalent program with a curriculum that includes Anatomy and Physiology, Pharmacology, Pathophysiology, Medical Terminology, ICD-9-CM/ICD-10 and CPT Coding Guidelines and Procedures.
Lead Inpatient Coder Thomas Jefferson UniversityLead Inpatient CoderPhiladelphia, PAThe Lead Inpatient Coder is a Health Information Management Professional possessing significant prior coding experience and a high level of coding proficiency, responsible for the assisting manangement with daily coding activities, department priorities and initiatives, precepting new staff, suggesting workflow enhancements, resolving billing edits and testing EHR updates. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research.
Clinical Coder Level I HIM Impatient Specialist (Full-Time, Remote) Penn MedicineClinical Coder Level I HIM Impatient Specialist (Full-Time, Remote)PARemoteCertification as a Certified Coding Specialist CCS or Certified Coding Specialist-Physician CCS-P through AHIMA American Health Information Association, or certified by AAPC American Association Professional Coders with certification as a Certified Professional Coder CPC, or Certified Professional Coder-Hospital Outpatient COC. Summary: Position Summary: Codes and abstracts information from inpatient and outpatient records by careful analysis and adherence to official coding guidelines assuring appropriate reimbursement, compliance with regulations, and accuracy for clinical care analysis and provider profiling.
Outpatient Coder Certified - Surgery Thomas Jefferson UniversityOutpatient Coder Certified - SurgeryPhiladelphia, PAJefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students.
Associate EMS Account Coder - Revenue Improvement Penn State Milton S Hershey Medical CenterAssociate EMS Account Coder - Revenue ImprovementCamp Hill, PAPenn State Health offers an exceptional benefits package including medical, dental and vision with no waiting period as well as a Total Rewards Program that highlights a few of the many additional offerings below: Be Well with Employee Wellness Programs, and Fitness Discounts (University Fitness Center, Peloton). Utilize the appropriate coding systems (ICD-10-CM, CPT, HCPCS) to accurately code diagnoses, services, and procedures performed by providers performing billable services.
NewCoder II - Technical (Inpatient Coding University of Pittsburgh Medical CenterCoder II - Technical (Inpatient CodingPittsburgh, PARemoteMaintain daily productivity statistics and submit a weekly productivity sheet to management clearly indicating the number of hours worked, the number of coding hours, the number of average charts per hour, and number of minutes/hours spent on non-coding tasks. Completed an AHIMA or AACP-certified Coding program or certificate, Bidwell Training School or equivalent program with a curriculm that includes Anatomy and Physiology, Pharmacology, Pathophysiology, Medical Terminology, ICD-9-CM/ICD-10 and CPT Coding Guidelines and Procedures.
Sr. Coder Thomas Jefferson UniversitySr. CoderPhiladelphia, PAJefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students.
Specialized Coder - Cardiology, Vascular and CVTS Ensemble Health PartnersSpecialized Coder - Cardiology, Vascular and CVTSWest Reading, PA$29.75–$32.70 / hourExtensive knowledge/experience in physician coding with expert knowledge in Cardiology, Cardiovascular Thoracic Surgery or Vascular Surgery coding specialty and the ability to provide education/support to coding team and providers. Remains abreast of changes to current payer guidelines, Correct Coding Initiative edits, and Local/National Coverage Determinations for accuracy in Coding and mentors team members regarding coding guidelines and accuracy.
Coder - Outpatient Highmark IncCoder - OutpatientPAIn connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy. Job Description: GENERAL OVERVIEW: This job performs thorough medical record review to abstract medical and demographic data, interpret and apply diagnoses and procedures utilizing ICD and CPT coding systems and assists in decreasing the average accounts receivable days.
NewInpatient Coder The LaSalle GroupInpatient CoderPittsburgh, PARemote$38–$40 / hourWith units specializing in Accounting and Finance, Administrative, Engineering, Marketing, Technology, Supply Chain, Revenue Cycle, Call Center, Human Resources and Executive Search, LaSalle offers staffing and recruiting solutions to companies of all sizes and across all industries. This Inpatient Coder position is designed for professionals who have worked in large hospital systems and can confidently code high-acuity cases.
Supervisor, Revenue Cycle Clinical Coder Denials | Enterprise Denials | Remote (FL, GA, MO, PA, NC, SC, TN, TX) University of Florida Health Science CenterSupervisor, Revenue Cycle Clinical Coder Denials | Enterprise Denials | Remote (FL, GA, MO, PA, NC, SC, TN, TX)PARemoteDemonstrated knowledge of hospital billing, reimbursement, denials and appeals, third-party payer contracts, insurance protocols, and revenue cycle workflows. Trains staff on revenue integrity policies, analyzes financial data for strategic insights, and implements improvements to optimize revenue capture.
Emergency Department Coder St. Luke's University Health NetworkEmergency Department CoderAllentown, PAIndividually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care. JOB DUTIES AND RESPONSIBILITIES: Codes and abstracts professional fee hospital services performed by SLPG physicians from medical records according to ICD-9/ICD-10, CPT-4, HCPCS II, and CMS guidelines.
Professional Fee Coder (Radiology exp required) St. Luke's University Health NetworkProfessional Fee Coder (Radiology exp required)Allentown, PAIndividually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care. JOB DUTIES AND RESPONSIBILITIES: Codes and abstracts professional fee hospital services performed by SLPG physicians from medical records according to ICD-9/ICD-10, CPT-4, HCPCS II, and CMS guidelines.
Per Diem Professional Fee PA/NJ Remote Coder St. Luke's University Health NetworkPer Diem Professional Fee PA/NJ Remote CoderAllentown, PARemoteIndividually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care. JOB DUTIES AND RESPONSIBILITIES: Codes and abstracts professional fee hospital services performed by SLPG physicians from medical records according to ICD-9/ICD-10, CPT-4, HCPCS II, and CMS guidelines.
Professional Fee Coder(Remote PA/NJ) St. Luke's University Health NetworkProfessional Fee Coder(Remote PA/NJ)Allentown, PARemoteIndividually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patients ability to pay for health care. Maintains daily productivity as outlined Responsible for maintaining up-to-date knowledge of coding guidelines as they relate to physician services for hospital inpatient, observation, consultant, surgical, critical care, and E & M services.
Certified Coder Mon Valley Hospital (On-Site) Penn Highlands HealthcareCertified Coder Mon Valley Hospital (On-Site)PASummary: As a CERTIFIED CODER, you will code hospital inpatient records and ambulatory outpatient records with a high degree of accuracy for the purpose of reimbursement, research and compliance with federal. This prestigious award is presented by Forbes and Statistica Inc., the world leading statistics portal and industry ranking provider.
Coder Commonwealth HealthCoderWilkes-Barre, PAUsing a computerized encoding system, assigns ICD-10-CM, ICD-10-PCS, CPT4/HCPCS, DRG and APCs in accordance with official coding and reimbursement guidelines from the American Medical Association, the American Hospital Association, and the American Health Information Management Association. The coder is responsible for abstracting all clinical and demographic data and accurately applying code assignment to all inpatient, outpatient, and emergency services with diagnoses, procedures and conditions as indicated in the patient medical record.
Coder - Inpatient (CCS/CIC REQUIRED), Remote, Sign on Bonus Eligible Highmark IncCoder - Inpatient (CCS/CIC REQUIRED), Remote, Sign on Bonus EligiblePARemoteIn connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy. GENERAL OVERVIEW: This job performs thorough medical record review to abstract medical and demographic data, interpret and apply diagnoses and procedures utilizing ICD coding systems and assists in decreasing the average accounts receivable days.
Coder I The Center for Orthopedic and Research ECoder IWest Chester, PARemotePart timeOur facilities include state-of-the-art MRI centers, outpatient surgery centers, physical therapy clinics, and orthopedic urgent care centers to ensure timely access to high-quality, patient-focused care. Premier Orthopaedics delivers expert treatment for orthopedic injuries, joint disease, interventional spine care, regenerative medicine, and comprehensive physical therapy services, supported by more than 150 providers across 50+ locations.
IP Facility Coder with CCS Presbyterian Healthcare ServicesIP Facility Coder with CCSPAWith minimal supervision directly supports the following responsibilities of the Coding and documentation quality assurance (CDQA) team: implementation of and compliance to enterprise-wide and department coding policies and procedures for PHS; compliance to all external regulatory agency coding rules and regulations; Demonstrates high-level of proficiency in performing and/or managing on-site internal audits or reviews to assess compliance/quality monitoring performed by PHS/PMG departments while serving as a resource on documentation, coding, billing, and coding compliance questions. Provides support via auditing and training the enterprise-wide corrective action plans for coding, audit, physician and clinician personnel identified as low performers; perform medical record and billing reviews of denied and appealed claims and takes appropriate action to ensure accurate payment of claims; coordinate review and tracking of appealed claims including the communication process with affected payers; research and interpret all regulatory agency regulations.
NewCoder III- Cardiology WellSpan HealthCoder III- CardiologyYork, PAReviews operative reports and other documentation and assigns appropriate diagnosis (ICD-10), procedure codes ( CPT-4), and other services (HCPCS) for final billing. Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.
Coder/Hosp/PRN Holy Redeemer Health System IncCoder/Hosp/PRNMeadowbrook, PAThe Senior Coding Specialist assigns diagnostic and procedural codes consistent with ICD-9-CM and CPT-4 guidelines, UHDDS sequencing guidelines, CMS coding guidelines, Medicare and Medicaid regulations and the American Hospital Association coding guidelines and in its publication, Coding Clinic and AMA's publication CPT Assistant. A graduate of an accredited hospital based coding program with certification of completion or successful completion of college credited course work in Medical Terminology, Anatomy & Physiology and Pathophysiology/Disease Processes/Pharmacology required.
Coder/Hosp/PRN Redeemer HealthCoder/Hosp/PRNMeadowbrook, PennsylvaniaSUMMARY OF JOB: The Senior Coding Specialist assigns diagnostic and procedural codes consistent with ICD-9-CM and CPT-4 guidelines, UHDDS sequencing guidelines, CMS coding guidelines, Medicare and Medicaid regulations and the American Hospital Association coding guidelines and in its publication, Coding Clinic and AMA’s publication CPT Assistant. A graduate of an accredited hospital based coding program with certification of completion or successful completion of college credited course work in Medical Terminology, Anatomy & Physiology and Pathophysiology/Disease Processes/Pharmacology required.
NewData Coder-Speech Therapy Student (Per Diem Temporary) Jefferson Moss-Magee Rehab Thomas Jefferson UniversityData Coder-Speech Therapy Student (Per Diem Temporary) Jefferson Moss-Magee RehabMontgomery County, PennsylvaniaThomas Jefferson University , home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research.
Medical Content Analyst, Specialist (Pre-Pay Policy) Lyric.aiMedical Content Analyst, Specialist (Pre-Pay Policy)PennsylvaniaLyric is an AI-first, platform-based healthcare technology company, committed to simplifying the business of care by preventing inaccurate payments and reducing overall waste in the healthcare ecosystem, enabling more efficient use of resources to reduce the cost of care for payers, providers, and patients. Leads client-facing discussions, serving as subject matter expert explaining ClaimsXten edit logic, content sourcing, rationale and expected outcomes to organizations that utilize Lyric’s edits for pre-payment editing.
Ambulance Medical Billing and Coding Associate DocGo IncAmbulance Medical Billing and Coding AssociatePARemote$21–$25 / hourDocGo's proprietary, AI-powered technology, logistics network, and dedicated field staff of over 5,000 certified health professionals elevate the quality of patient care and drive efficiencies for municipalities, hospital networks, and health insurance providers. About Ambulnz by DocGo: Ambulnz by DocGo is leading the proactive healthcare revolution with an innovative care delivery platform that includes mobile health services, population health, remote patient monitoring, and ambulance services.
Ambulance Medical Billing and Coding Associate DocGoAmbulance Medical Billing and Coding AssociatePennsylvaniaRemoteDocGo's proprietary, AI-powered technology, logistics network, and dedicated field staff of over 5,000 certified health professionals elevate the quality of patient care and drive efficiencies for municipalities, hospital networks, and health insurance providers. About Ambulnz by DocGo: Ambulnz by DocGo is leading the proactive healthcare revolution with an innovative care delivery platform that includes mobile health services, population health, remote patient monitoring, and ambulance services.
Medical Records Clerk University Health Services IncMedical Records ClerkPAResponsibilities The Medical Records Clerk manages, organizes, and maintains patient health records, ensuring accuracy, confidentiality, and accessibility for healthcare providers; Retrieve medical records for Providers, Patients, External sources and Staff; Ensure all records comply with HIPAA and other federal regulations, maintaining confidentiality and security of patient information. 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 all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom.
Director of Medical Records Eagleville HospitalDirector of Medical RecordsPAMaintain patient medical record system for the hospital in accordance with the policies of the hospital as well as The Joint Commission (TJC), Department of Drug and Alcohol Programs (DDAP), Department of Health (DOH), Office of Mental Health and Substance Abuse Services (OMHSAS), State and Federal law and other regulatory agencies. Conduct chart audits to assure that all appropriate documentation is included in the medical record and that the content is complete and accurate, has sufficient detail to reflect the treatment and services provided, the patient's course through treatment, the goals of treatment, and to support billing and coding functions.
Medical Coding Coordinator Pyramid, IncMedical Coding CoordinatorPhiladelphia, PAFull timeBring your drive for excellence, team orientation and customer commitment to Independence Client; help us renew and reimagine our business and shape the future of health care. If this describes you, we want to speak with you Ensures accurate medical coding related to technology assessments, medical policies, claim payment policies and adhoc coding projects.
Medical Billing & Coding/Receptionist Chestnut Hill Allergy & AsthmaMedical Billing & Coding/ReceptionistWyndmoor, PAThis role combines front desk responsibilities with medical billing and coding duties to help provide a smooth and positive patient experience from check-in through claim processing. The ideal candidate is professional, detail-oriented, able to multitask in a fast-paced environment, and has experience with insurance verification, medical billing, and customer service.
Physician Coding Auditor Ensemble Health PartnersPhysician Coding AuditorPARemote$57,400–$99,000 / yearThe Physician Coding Auditor develops and implements strategic needs analyses and training plans for coding leadership; coordinates and evaluates curriculum development and conducts the preparation and delivery of training for Medical Coders employed by Ensemble and providers that are contracted/employed and outlined in the client SOW. Educating - Assesses the educational needs of coding staff and providers that are contracted/employed and outlined in the client SOW (included Provider Education verbiage) and develops programs or researches educational resources to meet those needs.
Claims and Denial Coding Analyst St. Luke's University Health NetworkClaims and Denial Coding AnalystAllentown, PAProfessional Fee Radiology Coding and Billing Experience required 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, and ASCs across the network. Relevel TCM service when not supported by the documentation or TCM has been rendered during another TCM 30-day period Attends coding conferences, workshops, and in house sessions to receive updated coding information and changes in coding and/or regulations Assists with training new staff in all aspects of the Analyst role.
NewSupervisor Strategic Risk Adjustment and Quality Highmark IncSupervisor Strategic Risk Adjustment and QualityPAOversee the teams' processes to conduct multiple type of audits, government and internal, identify gaps, repeating issues and communicate results in provider office sites with data analysis from office site and/or medical record reviews to (a) continually improve the care, service to members and patient satisfaction; (b) coordination with other Highmark programs for credentialing, quality improvement programs, value based programs, care management programs, to achieve high caliber results, and (c) ensure medical records meet regulatory requirements. Contribute to the department's strategic planning efforts by identifying tactical opportunities for improvement, recommending solutions, and developing materials especially directed at Risk Adjustment, Quality/HEDIS, and Medical Record Documentation projects related to the development and implementation of educational opportunities.
Network Coordinator, Coding Audit & Education St. Luke's University Health NetworkNetwork Coordinator, Coding Audit & EducationAllentown, PAEDUCATION: Must maintain and be credentialed in at least ONE of the following AHIMA and/or AAPC recognized Professional Coding Certifications: Registered Health Information Technician (RHIT); Registered Health Information Administrator (RHIA); Certified Professional Auditor (CPMA); Certified Professional Coder (CPC); Certified); Certified Coding Specialist (CCS); In-depth knowledge of ICD CM, ICD PCS and CPT/HCPCS coding systems. Reviews and validates coded medical records to assess coding accuracy, documentation integrity, compliance risk, and reimbursement impact related to ICD-10-CM/PCS, CPT/HCPCS, DRG/APC assignment, modifiers, and applicable payment methodologies.
Senior Coding Data Quality Analyst - Provider Based SchuylkillSenior Coding Data Quality Analyst - Provider BasedPennsylvaniaRemoteFinally, Lehigh Valley Hospital - Cedar Crest, Lehigh Valley Hospital - Muhlenberg, Lehigh Valley Hospital- Hazleton, and Lehigh Valley Hospital - Pocono each received an 'A' grade on the Hospital Safety Grade from The Leapfrog Group in 2020, the highest grade in patient safety. frequent sitting/standing, frequent keyboard use, *patient care providers may be required to perform activities specific to their role including kneeling, bending, squatting and performing CPR.
Coding Auditor University Health Services IncCoding AuditorWAYNE, PAMeets continued education guidelines to maintain current AAPC CPC certification Exercises good judgement in escalating identified coding trends that may negatively impact productivity, quality or revenue to enhance clinical documentation to support codes billed, drive consistency across IPM, mitigate claim denials, expedite reprocessing of claims and maximize opportunities to enhance front end, coding-related claim edits to facilitate first pass resolution. 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 all over the U.S. states, Washington, D.C., Puerto Rico and the United Kingdom.
Hierarchical Condition Category (HCC) Coding Specialist Highmark IncHierarchical Condition Category (HCC) Coding SpecialistPAThis job will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA), using skills including but not limited to Hierarchical Condition Category (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment Data Validation (RADV) Audits. Flexes between coding projects, including Retro and Prospective, with different MA, ESRD, and ACA HCC Models; works independently in various coding applications and electronic medical record systems to support departmental goals.
Compliance Auditor - Billing Thomas Jefferson UniversityCompliance Auditor - BillingPhiladelphia, PennsylvaniaJefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. 1101 Market, Philadelphia, Pennsylvania, United States of America Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value.
NewBilling Supervisor The Primary Health NetworkBilling SupervisorSharon, PAEssential Function: Ensures the activities of the billing operations within the Network are conducted in a manner that is consistent with overall department protocol, and are in compliance with federal, state, and payer regulations, guidelines and requirements. The mission of Primary Health Network is to enhance the health and well-being of the communities we serve by fostering trust and ensuring inclusive and equitable access to healthcare that is both compassionate and exceptional.