- Elevance Health (Harrisburg, PA)
- ** Audit & Reimbursement II ** **_Location:_** _This role enables associates to work virtually full-time, with the exception of required in-person training ... Medicare and Medicaid Services to transform federal health programs. The ** Audit and Reimbursement II ** will support our Medicare Administrative Contract… more
- PNC (Pittsburgh, PA)
- …to contribute to the company's success. As a Business Resiliency Manager II within PNC's Business Resiliency organization, you will be based in Pittsburgh, ... may be performed remotely, at manager's discretion. The Business Resiliency Manager II will oversee a team of Resilience Professionals responsible for the Business… more
- Guthrie (Towanda, PA)
- …develop and train internal rejection protocols. Keeps current with coding knowledge, reimbursement policies, payer guidelines and other sources in order to ensure ... best practice procedures are followed. 5. Ensures staff adherence of protocols by audit and education. 6. Identifies and promptly reports payer, system or billing… more
- Centene Corporation (Harrisburg, PA)
- …changes and updates and submit change requests (CRs) to update payment system + Audit check run and send claims to the claims department for corrections + Identify ... a managed care environment. Knowledge of provider contracts and reimbursement interpretation preferred. **License/Certification:** CPC certification preferred. Pay Range:… more
- YesCare Corp (Philadelphia, PA)
- …expertise. **Key Responsibilities** + **Administrative Duties:** + Chair the Medical Audit Committee, ensuring quality standards are upheld. + Consult with community ... Discount and Rewards Program + Tuition Assistance + Continuing Education Reimbursement **Why Join YesCare?** YesCare provides a supportive and structured environment… more
- Highmark Health (Harrisburg, PA)
- …OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and ... coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure… more
- Veterans Affairs, Veterans Health Administration (Venango County, PA)
- …for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific eligibility requirements per VHA policy and ... of changing concepts and advancements in the profession Physician Assistant- II (PA- II ) - Intermediate Level Experience and...clinically in the development of the PA patient care audit processes involving in-depth review and analysis of medical… more
- Keurig Dr Pepper (Allentown, PA)
- …ThursdayOvertime, weekends, and holidays as needed The Production Technician II operates, monitors, troubleshoots, and maintains production and packaging equipment ... safety-first mindset + Keep work areas clean, organized, and audit -ready + Set up, operate, and monitor equipment and...sick leave) + 401(k) with company match + Tuition Reimbursement + Mileage Reimbursement _Benefits are subject… more
- UPMC (Pittsburgh, PA)
- …accuracy in code and charge selection, support internal and external audit reviews-including RAC-related audits-and approve account adjustments as appropriate. We're ... to accurately complete the coding process. + Investigate and resolve reimbursement issues, including denials, in a timely manner and demonstrate proficiency… more
- Highmark Health (Monroeville, PA)
- …and educational opportunities to employees. Forbes Hospital is a 315 bed, Level II trauma hospital located in the community of Monroeville. Our hospital offers the ... resource utilization. Also facilitates appropriate LOS, patient satisfaction and reimbursement for all patients. **ESSENTIAL RESPONSIBILITIES:** + Assumes role in… more