9 jobs found in Harrisburg

Become a part of our caring community The Medical Coder extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coder assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters, and manipulates databases. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Review medical documentation for clinical indicators to ensure correct...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and...

Job Description: The Med Grp Professional Billing (PB) Coder II is responsible for accurately resolving coding edits in assigned Epic WQ's and assigning ICD-10, CPT, and HCPCS coding classifications and modifiers based on clinical documentation and/or physician orders. This role ensures the integrity of data for both internal and external reporting, maintains work queues within processing timeframes, responds to inquiries related to billing codes, and adheres to compliance guidelines. Essential Functions Evaluates and resolves all types of coding edits in assigned Charge Review, Claim Edit, and Follow-up work queues in Epic. Assigns ICD, CPT, and HCPCS coding classifications based on clinical documentation and/or physician orders. Accurately evaluates and resolves assigned coding edits in Charge Review, Claim Edit, and Follow-up work queues in Epic within assigned timeframes. Appropriately escalates coding/denial trends and provider education...

Penn State Health - Penn State Health Medical Group LLC Location: US:PA:Harrisburg Work Type: Full Time FTE: 1.00 Shift: Day Hours: 8:00a to 4:30p, occasional varied start time Provides direct supervision of practice site clerical support staff to provide optimal clinical operations. Responsible for clerical supervision and management including; cost effective management of office supplies, high integrity adherence with organizational policies surrounding quality of patient registration, point of service cash collections and cash control, scheduling, and other clerical support functions, patient satisfaction with clerical staff experience, and clerical staff employee engagement. Abides by, and upholds in performance of direct reports, all related local, state, federal and accrediting body rules and regulations; promotes an exceptional patient experience, by providing customer service support and guidance to staff, and through the use of scenario discussions at staff meetings....

Job Opportunity Position Overview: We are seeking a Registered Nurse (RN) to review and evaluate medical necessity, appropriateness, quality, and compliance of services rendered by providers. This role involves claims analysis, provider audits, fraud detection, and regulatory enforcement to ensure compliance with state and federal regulations. Key Responsibilities: Analyze claims data, medical records, and provider documentation to identify discrepancies, fraud, or non-compliance. Conduct retrospective case reviews, on-site provider audits, and recipient interviews. Review billing practices for upcoding, duplicate billing, and unbundling of services using ICD-10, CPT, and HCPCS manuals. Prepare reports, case findings, and recommend sanctions when violations are identified. Coordinate and participate in teleconferences, hearings, and legal proceedings with the Office of General Counsel and other agencies. Respond to provider complaints and compliance inquiries via hotline,...

Become a part of our caring community Code Edit Disputes team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The Medical Coding Coordinator performs advanced administrative, operational, and customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills. Where you Come In The Medical Coding Coordinator extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Decisions typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques, and...

Salary: $46,827.00 - $70,592.00 Annually Location : Greene County, PA Job Type: Civil Service Permanent Full-Time Job Number: CS-2026-55091-39010 Department: Department of Corrections Division: CR GRN Med Opening Date: 07/29/2026 Closing Date: 8/12/2026 11:59 PM Eastern Job Code: 39010 Position Number: 00203115 Union: AFSCME Bargaining Unit: A2 Pay Group: ST05 Bureau / Division Code: 00113630 Bureau / Division: Department of Corrections - State Correctional Institution at Greene Worksite Address: 169 Progress Drive City: Waynesburg, Pennsylvania Zip Code: 15370 Contact Name: Trisha Pratt Contact Phone: 717.317.5339 Contact Email: tpratt@pa.gov THE POSITION Are you a highly motivated person with great attention to detail and leadership skills? The Department of Corrections, State Correctional Institution (SCI) at Greene is seeking a Medical Records Supervisor. This position offers an opportunity to support accurate...

Salary: $46,827.00 - $70,592.00 Annually Location : Somerset County, PA Job Type: Civil Service Permanent Full-Time Job Number: CS-2026-55479-39010 Department: Department of Corrections Division: CR LAU Med Opening Date: 08/04/2026 Closing Date: 8/17/2026 11:59 PM Eastern Job Code: 39010 Position Number: 00232530 Union: AFSCME Bargaining Unit: A2 Pay Group: ST05 Bureau / Division Code: 00114430 Bureau / Division: SCI Laurel Highlands Worksite Address: 5706 Glades Pike City: Somerset, Pennsylvania Zip Code: 15501 Contact Name: Corleen Schmucker Contact Phone: 717.562.5736 Contact Email: cschmucker@pa.gov THE POSITION Become a key part of the Department of Corrections (DOC) as the Medical Records Supervisor at the State Correctional Institution (SCI) at Laurel Highlands. In this role, you help maintain essential medical information that supports inmate treatment and keeps the medical unit operating efficiently. Your...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world’s health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient’s request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you’re stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. What We’re Looking For We’re looking for experienced and credentialed inpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing...