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The Director collaborates closely with providers and leadership across Risk Adjustment, Population Health, Practice Operations, Quality, Finance, Analytics, Clinical Operations, and RBE partnerships to ensure BOI initiatives are coordinated, compliant, measurable, and successfully implemented. This role uses data and performance trends to identify opportunities, establish organizational and practice-level priorities, and develop programs that improve documentation, coding accuracy, condition recapture, prevalence, and overall value-based care outcomes.

Millennium Physician Group

Director, Clinical Excellence/Boi

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Other skills include the ability to analyze, act and design action plans upon monthly and quarterly reports related to individual providers, facilities, MS-DRGs, APR, PSIs, severity of illness and risk of mortality, capture rates, quality metrics and can effectively prioritize their work activities. Clinical Payments Optimization: Assisting clients by validating that payments for clinical healthcare services comply with regulatory, clinical based evidence and contractual requirements while also determining that payments are appropriate for the type and level of care provided.

YEAR

Deloitte

Senior Consultant - Clinical Documentation Specialist

Follows directive of composing appeal letters to include appropriate data extraction, construction of well-written appeals letters with proper grammar, utilization of appeal tools including pre-constructed templates, and inclusion of appropriate medical literature references. They will have a working knowledge encoder use and selecting appropriate, supportable appeal arguments from evidence-based, peer reviewed medical literature as provided as well as interpreting and utilizing ICD 9 and 10, CM and PCS, CPT coding system, and HCPCS guidelines.

UnitedHealth Group is a health care and well-being company that’s dedicated to improving the health outcomes of millions worldwide. We are comprised of two distinct and complementary businesses, UnitedHealthcare and Optum, working to build a better health system for all. Here, your contributions matter as they will help transform health care for years to come. Make an impact with a diverse team that shares your passion for helping others.

What we do

Gain insights on how we work to help people live healthier lives and help make the health system work better for everyone by watching this video.

<a href="https://www.youtube.com/watch?v=5PbNyi2IDkY">https://www.youtube.com/watch?v=5PbNyi2IDkY</a> 

Caring. Connecting. Growing together. 

Being a part of UnitedHealth Group means working to improve health outcomes for everyone, including yourself. Here is how:

• Caring. Your total health and well-being are important to us. Whatever matters most to you — we have resources to help you be your best at work and at home. The benefits range from free Peloton courses to financial counseling. <a href="https://careers.unitedhealthgroup.com/culture/what-we-offer/">Learn more about what we offer.</a> 

• Connecting. We recognize our collective power to make an impact across our communities because we believe the health of any society is measured by the overall health of its people. <a href="https://careers.unitedhealthgroup.com/culture/">Learn more about our culture.</a> 

• Growing together. UnitedHealth Group is full of inspiring career stories, and we offer a lifetime of opportunities. <a href="https://careers.unitedhealthgroup.com/career-areas/">Discover all the ways you can learn, grow and develop.</a>

UnitedHealth Group Inc

Utilization Management & Clinical Validation RN

Then join Temple Physicians, Inc. '',''Pennsylvania-Philadelphia'',''Pennsylvania-Philadelphia'',''Operational Admin & Management'',''Operational Admin & Management'',''Full-time'',''Full-time'',''Day Job'',''Day Job'',''Regular'',''Regular'',''false'',''404112'',''404112'',''true'',''404112'',''false'',''Submission for the position: Service Line Coding Administrator (40 hrs/Days/Hybrid)(Temple Health) - (Job Number: 262753)'',''false'',''404112'',''false'',''true''. ''404112'',''true'',''404112'',''false'',''Submission for the position: Service Line Coding Administrator (40 hrs/Days/Hybrid)(Temple Health) - (Job Number: 262753)'',''false'',''404112'',''false'',''true'',''Service Line Coding Administrator (40 hrs/Days/Hybrid)(Temple Health)'',''262753'',''!*!

Temple University Health System

Service Line Coding Administrator (40 hrs/Days/Hybrid)(Temple Health)

REQURIED SKILLS: Effective and efficient organization and planning skills with the proven ability to manage complex multi-workstream performance improvement projects or multiple concurrent client engagements, while delegating and overseeing the work of junior team members. is directly responsible for the daily oversight of coding operational processes and workflow, including but not limited to delivering timely and accurately coded cases for facility billing and for reporting hospital and provider quality metrics.

Huron Consulting Group

Inpatient Coding Manager

A license in one of the following is preferred: Certified Coding Specialist (CCS), Licensed Practical Nurse (LPN), Licensed Master Social Work (LMSW), Licensed Vocational Nurse (LVN), Licensed Mental Health Counselor (LMHC), Licensed Marital and Family Therapist (LMFT), Licensed Certified Social Worker (LCSW), Licensed Registered Nurse (RN), Acute Care Nurse Practitioner (APRN) (ACNP-BC), Other Foreign trained physician/MD, Health Care Quality and Management (HCQM), Certified Healthcare Professional (CHP), Certified Professional in Healthcare Quality (CPHQ). Education/Experience: A bachelor's Degree in Healthcare, Public Health, Nursing, Psychology, Health Administration, Social Work or related field or equivalent work experience within a managed care environment related to HEDIS record review, quality improvement, medical coding or transferable skill sets that demonstrates the ability to perform the role is required.

HOUR

Centene Corporation Group

Associate Quality Practice Advisor

With annual net revenue in excess of $4 billion, the Network's service area includes 11 counties in two states: Lehigh, Northampton, Berks, Bucks, Carbon, Montgomery, Monroe, Schuylkill and Luzerne counties in Pennsylvania and Warren and Hunterdon counties in New Jersey. Luke's University Health Network (SLUHN) is a fully integrated, regional, non-profit network of more than 23,000 employees providing services at 16 campuses and 350+ outpatient sites.

St. Luke's University Health Network is a regional network of hospitals, physicians and other related organizations providing care primarily in Lehigh, Northampton, Monroe, Carbon, Schuylkill, Bucks, Montgomery and Berks counties in Pennsylvania and Warren County in New Jersey. The Network provides services at more than 150 sites. St. Luke's University Health Network is comprised of six hospital sites. The Network includes:<ul> <li> More than 80 owned physician-practice sites </li><li>300 employed primary care/specialist physicians </li><li>Various outpatient testing and service facilities</li><li>Home health </li><li>Hospice services (inpatient and outpatient)</li><li>Largest ambulance provider in Bucks County and second largest in Lehigh County</li><li>Other related organizations</li><li>57,500+ annual admissions</li><li>195,000 annual emergency room visits</li><li>1,325 physicians on the Medical Staff (96 percent board-certified)</li><li>8,600+ employees</li><li>More than 1,350 volunteers </li></ul> Areas of exceptional medical expertise include:<ul> <li>Level 1 Adult Trauma Center: fully accredited by Pennsylvania Trauma Systems Foundation; 2,400+ annual trauma cases; St. Luke's 1.75 percent mortality rate represents top decile performance, significantly better than peer group as measured by National Trauma Data Bank of the American College of Surgeons; aeromedical transport services</li><li>Oncology: first and only cancer program in Pennsylvania to receive American College of Surgeons' highest quality recognition for three consecutive years; only Pennsylvania program to receive award in 2010; region's only fellowship-trained surgical oncologists; advanced programs for melanoma (internationally recognized melanoma investigator), lung, breast, prostate, gynecologic and gastrointestinal cancers and tumors of the brain and spine</li><li>Cardiology and Cardiovascular Surgery: multiple-year recipient of highest rating for cardiac bypass surgery, represents top decile performance achieved by only 10 percent of U.S. hospitals (Society for Thoracic Surgery); region's first Joint Commission certified Heart Failure Program; comprehensive surgical services excluding heart transplants </li><li>Neuroscience: accredited Stroke Center; additional Centers of Excellence include: Balance Center, Headache Center, Memory Disorders Center, Multiple Sclerosis Center, Sleep Disorders Center</li><li>Orthopaedics: advanced expertise in total joint replacement and reconstruction, computer-assisted minimally invasive surgery, primary and reconstructive surgery of the spine, sports injuries, diseases and conditions of the hand and elbow, traumatic injuries </li><li>Women's/Children's Health: high-risk pregnancy; the region’s busiest obstetrical service; two neonatal intensive care units; pediatric specialty care provided by St. Christopher's Hospital for Children.</li><li>Robotic/Minimally Invasive Surgery: one of the nation's most experienced robotic surgical teams</li><li>Radiology: designated international General Electric Healthcare Show Site for imaging technology; designated Breast Imaging Center of Excellence by American College of Radiology</li><li>Bariatric Surgery: designated Center of Excellence by American Society for Metabolic and Bariatric Surgery and Surgical Review Corporation</li> </ul> St. Luke's offers an exceptional benefit plan for employees. Our values are reflected in all we do for patients, each other and the community: Pride - We take pride in our accomplishments and in our organization. Caring - We show consideration for others and their feelings. We treat others as we want to be treated. Respect - We recognize the value, diversity and importance of each other, those we serve and the organization. Accountability - We are responsible to make decisions and solve problems in a timely and effective manner. Flexibility - We adapt to the changing needs and expectations of those we serve. Teamwork - We work together to improve quality. The mission of St. Luke's University Health Network 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.

Medical Coder Jobs in Pennsylvania

Director, Clinical Excellence/Boi Millennium Physician Group

Senior Consultant - Clinical Documentation Specialist Deloitte

Utilization Management & Clinical Validation RN UnitedHealth Group Inc

Service Line Coding Administrator (40 hrs/Days/Hybrid)(Temple Health) Temple University Health System

Inpatient Coding Manager Huron Consulting Group

Associate Quality Practice Advisor Centene Corporation Group

Inpatient Coding Specialist (Remote - Full Time | PA & NJ Candidates) St. Luke's University Health Network

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