14 jobs found in Harrisburg, PA

Become a part of our caring community and help us put health first The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. 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...

Welbehealth Pace Coding Auditor And Educator WelbeHealth PACE (All-Inclusive Care for the Elderly) program provides seniors with the opportunity to continue living in their homes and in their communities. Our innovative and comprehensive range of medical services to participants is what ignites our passion to treat the whole person and not the symptoms! We employ a collaborative interdisciplinary team (IDT) approach to evaluate and guide participant care, which is key to WelbeHealth values, team culture, and mission. At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate and properly supported by clinical documentation within the health records, as well as educating our teams on best practices to promote compliance. Essential Job Duties: Assist with retrospective and concurrent coding for PACE (All-inclusive Care for the Elderly) Dual participants Conduct pre-visit chart preparations and post-visit chart reviews...

Remote Medical Biller (Dental Claims) We are seeking a detail-oriented Medical Biller to join our team. The primary responsibility of this role is entering and managing insurance claims using dental billing software. The ideal candidate will have prior experience in medical or dental billing, strong attention to detail, and the ability to work independently in a remote setting. Key Responsibilities: Accurately enter dental insurance claims into the billing software Review patient records to ensure accurate claim submission Verify insurance information and eligibility as needed Follow up on unpaid or denied claims to ensure timely reimbursement Maintain organized digital records of all billing activities Communicate with dental offices, insurance providers, and patients when necessary Ensure compliance with HIPAA and other billing regulations

Medical Coding Auditor Become a part of our caring community and help us put health first. The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/HCPCS code assignments. Analyzes, enters and manipulates database. 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...

Become a part of our caring community and help us put health first The 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 Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the...

Job Description 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...

Coding Specialist Location Detail: 9 Farm Springs Rd Farmington (10566) Shift Detail: 100% Remote Position Work where every moment matters. Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut's most comprehensive healthcare network. The creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole, rather than a single member organization. With the creation of our new umbrella organization we now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system. Position Summary Reviews inpatient clinical documentation to determine the appropriate assignment of alpha numeric...

Job Title This is a 100% remote position. Responsibilities The Coder is responsible for the accurate, timely, and accountable coding of the providers' clinics charges. Responsible for insuring all clinics charges are captured and billed in a timely manner. Provides education and assistance to all employees with respect to correct coding. Works with practice manager to insure all coding/billing references are current and accurate. Qualifications High School diploma, Certified Professional Coder (CPC) certification or Certified Coding Specialist, Physician-Based (CCS-P) preferred. Minimum 3 year's ENT coding experience preferred. Proficient computer skills; excellent communication and English Grammar skills; proficient at spreadsheet development and maintenance; extensive knowledge of practice management system file maintenance. Experience with clinic coding preferred.

Coding Specialist Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. Job Summary Coding Specialists are an important part of the Team at CorroHealth. The Coding Team Member will provide CPT, HCPCS, and ICD-10-CM coding a minimum of 1-4 specialties. Will be Coding Professional Fee, Facility, or HCC. Professional Fee Specialties could include UR, Podiatry, Plastics, Pediatrics, OB, Pain Management, Ortho, Addiction, General Surgery, Internal Medicine, Urgent Care, Pulmonary, or ED. Facility Chart types could include OT, PT, Urgent Care, ED, or a...

Hcc Coder Position Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. As an HCC (Hierarchical Condition Category) coder you will review medical records to identify and code diagnoses using a standardized...

Discover. Achieve. Succeed. #BeHere A minimum of three years of experience as an inpatient coder at an academic facility is preferred. Bachelor's degree in HIM or equivalent is preferred. Pay is expected to be between: $24.05 - $38.48. Final compensation is based on experience and will be discussed with you by the recruiter during the interview process.

Coding Position This level 2 coding position provides support to the Enterprise Coding Department for coding of physician's fees and/or facility fees. This position requires experience in coding and requires certification with AAPC or AHIMA. Function/Duties of Position Coding Review clinical documentation of services to be coded in EPIC, and any other source of documentation available to ensure compliance with the Center for Medicare and Medicaid Services (CMS). Assign correct CPT, ICD-10-CM, and HCPCS codes for facility and/or professional charges, which could include E&M services; diagnostic services; procedural services; facility services; and/or Charge Routers and Charge entry. Establish and maintain procedures and other controls necessary in carrying out all procedure and diagnostic coding and insurance billing activity for applicable work queues assigned in facility and/or professional services at OHSU. Monitor activity for compliance with federal and/or state...

Caring. Connecting. Growing Together. Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Schedule: This position is full-time (40 hours/week). Employees will work Monday - Friday with flexible hours. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Identify appropriate assignment of CPT and ICD-10 Codes for Professional Multis-specialty E/M and Surgical services while adhering to the official coding guidelines and...

11/24/25 At TE, you will unleash your potential working with people from diverse backgrounds and industries to create a safer, sustainable and more connected world. Job Description: Day-to-Day Job Overview Develop new and revise existing firmware Full Software Development Lifecycle according to DO-178 Gitlab pipelines for test automation Generate deliverables and documentation This is a fully remote position. Job Requirements SW Architecture Design, Planning and Documentation Programming Arm Cortex microcontrollers Programming 16-bit PIC microcontrollers Serial communications protocols (RS485, SPI, I2C, 1553, ARINC 429 & 825, CAN) Non-volatile Memory, EEPROM Emulation, ROM, storage of configuration constants Cybersecurity requirements including boot protection, image verification, NVM CI/CD using GitLab DO-178 development expertise MISRA-C linting Writing and utilizing bootloaders Excellent debugging methodology and tools...