12 jobs found in Pittsburgh

UPMC Corporate Revenue Cycle Hiring A Coder II UPMC Corporate Revenue Cycle is hiring a Coder II to join our Coding Department! This position will be a work-from-home position working Monday through Friday during business hours. In this position, you will be working on coding for the UPMC Cancer Centers. As a Coder II, you will review all pertinent physician, nursing and ancillary documentation in the medical record. Depending on type of service and place of service, you will determine the level of acuity, procedure performed, billable supplies and diagnosis to substantiate medical necessity. You will review and sequence all codes to maximize reimbursement and address any potential bundling issues. Apply modifiers as needed. LMRP/CCI edit and coding denial resolution responsibilities include: Utilize computer applications and resources essential to completing the coding process efficiently. Meet and maintain charge lag and appropriate coding productivity standards within...

Job Description Job Description Description: About e4health At e4health, our vision is to Empower Better Health for our clients, our team, and the communities we serve. We live by five core values that guide everything we do: Embrace Change, Fun, and Learning: We maintain an unrelenting focus on quality, client success, and team member growth. Our PEOPLE Make the Difference: We build trusted relationships and celebrate wins every day. WE GROW: We believe in win/win outcomes—when our customers win, we win. GSD (Get Stuff Done): We say no to politics, drama, and egos, and yes to informed, agile decisions. Respectfully Listen, Challenge, & Support Each Other: We listen intently, challenge respectfully, and support fully. Serving more than 400 hospitals and health systems nationwide for nearly two decades, e4health provides solutions to tackle the toughest problems in healthcare with unmatched technology, mid-revenue cycle, and operational expertise. Our...

Job Description Job Description Description: About e4health At e4health, our vision is to Empower Better Health for our clients, our team, and the communities we serve. We live by five core values that guide everything we do: Embrace Change, Fun, and Learning: We maintain an unrelenting focus on quality, client success, and team member growth. Our PEOPLE Make the Difference: We build trusted relationships and celebrate wins every day. WE GROW: We believe in win/win outcomes—when our customers win, we win. GSD (Get Stuff Done): We say no to politics, drama, and egos, and yes to informed, agile decisions. Respectfully Listen, Challenge, & Support Each Other: We listen intently, challenge respectfully, and support fully. POSITION TITLE: HCC Auditor ROLE TYPE: Full Time (32+hours) / Part Time (25-30 hours) EMPLOYMENT TYPE: Non-Exempt JOB SUMMARY: The HCC Auditor is responsible for completing quality assurance reviews on internal or...

Job Description Job Description Medical Billing Specialist 100% Remote $1822/hour | Full-Time | Permanent Opportunity We're growing and looking for experienced Medical Billing Specialists to join our fully remote team! In this role, you will focus on back-end A/R follow-up, denial resolution, and aged account remediation for Hospital and/or Physician Billing accounts. Our team partners with healthcare providers and hospital organizations to deliver revenue cycle and accounts receivable support services. If you thrive in a fast-paced environment, enjoy problem solving, and have experience working insurance denials and unpaid claims, we'd love to hear from you. Why Join Us? 100% Remote Flexible Schedule Health, Dental, Vision, and Life Insurance PTO, Paid Sick Leave, and Paid Holidays Career Growth Opportunities What Youll Do: Perform second-tier insurance account follow-up on outstanding A/R balances Resolve denied, underpaid, and unresolved...

Job Description Job Description Description: About e4health At e4health, our vision is to Empower Better Health for our clients, our team, and the communities we serve. We live by five core values that guide everything we do: Embrace Change, Fun, and Learning: We maintain an unrelenting focus on quality, client success, and team member growth. Our PEOPLE Make the Difference: We build trusted relationships and celebrate wins every day. WE GROW: We believe in win/win outcomes—when our customers win, we win. GSD (Get Stuff Done): We say no to politics, drama, and egos, and yes to informed, agile decisions. Respectfully Listen, Challenge, & Support Each Other: We listen intently, challenge respectfully, and support fully. Serving more than 400 hospitals and health systems nationwide for nearly two decades, e4health provides solutions to tackle the toughest problems in healthcare with unmatched technology, mid-revenue cycle, and operational expertise. Our...

Coder IIUPMC Corporate Revenue Cycle is hiring a Coder II to join our Coding Department! This position will be a work-from-home position working Monday through Friday during business hours.In this role, you will be handling outpatient coding CCI edits. Coding diagnosis & procedure codes ICD-10 & CPT codes and charging for injections, infusions, hydrations, and reconciling NCCI edits. Responsibilities include:Review coding for accuracy and completeness prior to submission to billing system utilizing CCI edits. Utilize standard coding guidelines, principles and coding clinics to assign the appropriate ICD-10-CM, CPT and DSM IV codes for all record types to ensure accurate reimbursement. (i.e. use of coding clinics, CPT Assistant, etc). Utilize the ACEP acuity level guidelines for assigning the correct acuity level for ED coding, or hospital specific acuity level module as needed.Adhere to internal department policies and procedures to ensure efficient work processes. Actively...

UPMC Corporate Revenue Cycle Hiring Coder I- TechnicalUPMC Corporate Revenue Cycle is hiring a Coder I- Technical to join our inpatient coding team! This position will work during daylight business hours, Monday through Friday. The position will work fully remote! The position assigns ICD-10-CM diagnosis codes and ICD-CM-PCS procedure codes for all UPMC inpatient facilities.Are you looking to start your career in coding? If so, this could be the opportunity for you! Responsibilities:Code all diagnoses and procedures by assigning and verifying the proper ICD-10-CM and PCS codes. Assign the principal and secondary diagnoses and procedures by thoroughly reviewing all documentation available at the time of coding.Determine diagnoses that were treated, monitored and evaluated and procedures done during the episode of care and assign appropriate codes. Review appropriate documents in the patients' charts to accurately assign a diagnosis and/or procedure. Ensure the diagnoses and...

We are seeking a detail-oriented and experienced Medical Billing Specialist with a strong background in medical billing, coding, and insurance processes. The ideal candidate will be skilled in medical terminology, procedure coding, cost estimation, insurance appeals, and working within electronic health record systems. This role requires accuracy, excellent communication skills, and the ability to work with both patients and payers to ensure timely and correct reimbursement. This position may offer the opportunity to work from home, depending on experience and performance. Key Responsibilities: Accurately process and submit medical claims to insurance companies, government payers, and other third-party organizations. Perform medical coding using ICD-10, CPT, and HCPCS standards for a variety of procedures and diagnoses. Generate and communicate cost estimates for procedures based on insurance coverage and contract agreements. Review and verify accuracy of billing data within...

UPMC Corporate Revenue Cycle is hiring a Certified Professional Coder to join our coding team to work on Cardiology coding. This position will be a work-from-home position working Monday through Friday during normal business hours. To be considered for this position, you must have three years of coding experience. In this role, you will have the same responsibilities as Coder II, but also be responsible for assigning PQRS codes and assist in the development of templates and processes to obtain the appropriate documentation. Provide feedback to the physicians on coding, documentation, edit, and denial issues. Responsibilities: Identify incomplete documentation in the medical record and formulate a physician query to obtain missing documentation and/or clarification and provide education to physicians to accurately complete the coding process. Refer problem accounts to appropriate coding or management personnel for resolution. Make forward progress within the training...

UPMC Corporate Revenue Cycle is hiring a Coder III to join our Coding Department! This position will be a work-from-home position, working Monday through Friday during business hours. In this role. you will monitor and respond to accounts on Pre-Bill edit and error reports. You will assist with training other coders as requested. The Coder III will perform PHC4 coding corrections; provide feedback to coders who made errors as well as monitor the Daily Cirius Error report to ensure that there are zero accounts exceeding the expected completion timeframe. Additionally, you will review and respond to the Pre-Bill Edit report issues to ensure timely billing. As the Coder III, you will assist with special projects as requested. We are seeking experienced Coders with a strong background in Interventional Radiology (IR) and Interventional Cardiology (IC) CPT coding. Qualified applicants should possess a minimum of three years of CPT coding experience. If you are ready to take the...

Experienced Associate, Healthcare ForensicsThe Experienced Associate, Healthcare Forensics role is a highly analytical and detail-oriented individual responsible for identifying, analyzing, and resolving payment inaccuracies across healthcare claims as it relates to reimbursement disputes, fraud, waste, and abuse investigation, regulatory compliance, and litigation. The ideal candidate will bring a strong understanding of healthcare reimbursement methodologies, claims data, and regulatory frameworks. The Experienced Associate, Healthcare Forensics demonstrates an investigative mindset with problem solving skills and the ability to think critically about data to deliver high-quality work product for clients.Job Duties:Provides investigation and analysis to a variety of clients, including outside counsel, regulators, and companies involved in litigation, investigation, dispute, regulatory, and compliance mattersContributes to forensic engagements related to medical coding and...

Coder IIIUPMC Corporate Revenue Cycle is hiring a Coder III to join our Coding Department! This position will be a work-from-home position working Monday through Friday during business hours.This position will be working on inpatient codes. As the Coder III, Technical you will code all inpatient accounts, ICD10 diagnoses, and PCS procedures. Responsibilities:Code all diagnoses and procedures by assigning and verifying the proper ICD-10-CM and PCS codes following review of the medical record in the electronic health record. Assign the principal and secondary diagnoses and procedures by thoroughly reviewing all documentation in the EHR available at the time of coding adhering to Official Coding Guidelines.Review coding for accuracy and completeness prior to submission to billing system utilizing CCI edits as published in Optum. Utilize standard coding guidelines, principles and coding clinics to assign the appropriate ICD10-CM and PCS codes for all record types to ensure accurate...