- Highmark Health (Harrisburg, PA)
- …of a grievance/appeal; documents, investigates, refers and coordinates grievances and appeals ; initiates a case file for each grievance and appeal; ensures ... all involved parties. + Participate in workgroup meetings to address trends in appeals and grievances and to work on process improvement initiatives with cross… more
- Penske (Reading, PA)
- **Position Summary:** The Tax Analyst is an integral member of the Fleet Services Organization. This dynamic position will be responsible for providing analysis and ... audits, including negotiating with auditors and interfacing with taxing jurisdictions. -Perfect appeals and refund claims. -The position will require the ability to… more
- UPMC (Pittsburgh, PA)
- …can drive impactful decisions? UPMC Corporate Finance is seeking a **Senior Reimbursement Analyst ** to join our dynamic team and play a pivotal role in shaping ... the nation's leading healthcare providers. **Purpose:** As a Senior Reimbursement Analyst , you'll lead complex financial analysis projects, mentor junior analysts,… more
- Evolent (Harrisburg, PA)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** ** Analyst , Client Analytics** Integrate and analyze claims and enrollment data from multiple ... Evolent's clinical services (ie, specialty care, utilization management, care management, appeals & grievances) + Using analytical tools to integrate various data… more
- Intermountain Health (Harrisburg, PA)
- …updates to charging/coding/NCCI regulations and/or errors, and regarding audits and appeals , to facilitate corrective action planning for improved processes. 7. ... Complies with all CMS, Federal and State regulations, and payor guidelines, and ensures consistent and compliant application with charge/coding capture, charge editing, and audit and reimbursement practices. Researches and collaborates on regulation updates to… more
- DXC Technology (Harrisburg, PA)
- …Job Functions** + Request and review documentation from the law firms and review appeals from the firms on our decisions. + Act as the liaison between our ... customers, typically Property and Casualty Insurance Carriers, and their law firms. + Achieve weekly and monthly goals regarding the number and dollar amount of the law firm invoices that they must review. + Become proficient in the analysis of one customer's… more
- Guthrie (Sayre, PA)
- …well as identifies, analyzes and takes the necessary action to submit complex appeals to insurance payers. Reviews all medical chart and account documentation in ... to determine appropriate coding and initiate corrected claims and appeals . Interprets payer guidelines, regulatory guidelines, contractual obligations and works… more
- Intermountain Health (Harrisburg, PA)
- **Job Description:** The HIM Coding Audit Training Analyst Coordinator provides advanced training to hospital coding staff, compliance, CDI, physicians, and clinical ... providers, clinical staff, compliance and the CDI team. + Audits and creates appeals for all payer and regulatory denials and downgrades and provides in-depth coding… more