52 jobs found in Enola, PA

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Senior auditor responsible for clinical or physician compliance topics. Assigned the most complex clinical/documentation/coding/billing reviews. Provides guidance to other auditors within AHN on audit approach and analysis. Responsible for creating and overseeing orientation of auditors. Leads all hospital or physician audits/investigations, auditing support and responses related to external audit activity. ESSENTIAL RESPONSIBILITIES: Establishes and implements orientation for all members of the AHN audit compliance team. Evaluates the progress of team members including review of reports and audit activities. Works with senior management responsible for AHN-wide case management/physician programs to develop processes that meet Medicare and 3rd party payor requirements. Provides guidance to staff auditors on audit topics and reports. (20%) Conducts educational sessions for...

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...

Fully Remote Lake Park Building Full time R182990 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...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. Position Summary The Certified Professional Coder (CPC) will perform medical claim reviews to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Activities include: Conduct a...

Salary: $46,827.00 - $70,592.00 Annually Location : Somerset County, PA Job Type: Civil Service Permanent Full-Time Job Number: CS-2026-58314-39010 Department: Department of Corrections Division: CR LAU Med Opening Date: 09/14/2026 Closing Date: 10/13/2026 11:59 PM Eastern Job Code: 39010 Position Number: 00232530 Union: AFSCME Bargaining Unit: A2 Pay Group: ST05 Bureau / Division Code: 00114430 Bureau / Division: State Correctional Institution at 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 The Medical Records Supervisor with the Department of Corrections plays an important role in supporting quality health care. This position offers a chance to guide staff and improve recordkeeping systems. The work helps ensure that inmates receive accurate and timely medical...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: This job performs thorough medical record review to abstract medical and demographic data, interpret and apply diagnoses and procedures utilizing ICD and CPT coding systems and assists in decreasing the average accounts receivable days. ESSENTIAL RESPONSIBILITIES Reviews and interprets medical information, physician treatment plans, course, and outcome to determine appropriate ICD-10 CM/CPT codes for diagnoses and procedures. (65%) Abstracts data elements to satisfy statistical requests by the hospital, health system, medical staff, etc. and enters all coded/abstracted information into designated system. (15%) Ensures efficient management of medical information and cash flow as it pertains to the unbilled coding report. (10%) Keeps informed of the changes/updates in ICD-10 CM/CPT guidelines by attending appropriate training, reviewing coding clinics and other resources...

We are so glad you are interested in joining Sutter Health! Organization: SHSO-Sutter Health System Office-Valley Position Overview: This position conducts review of outpatient medical records using International Classification of Disease Coding ICD-10-CM and Current Procedural Terminology (CPT), Medicare Advantage, ICD-10-CM, and Centers for Medicare and Medicaid Services (CMS) coding and reporting guidelines. Performs medical record reviews to ensure accurate assignment of medical diagnoses and procedures. Responsible for pre-appointment review of each encounter in scope, including Medicare Advantage encounters, to ensure accurate reporting of diagnoses and to alert the physician of potential clinical conditions that may require review. This position will support risk adjustment code validation for CMS and HHS Risk Adjustment models Job Description : EDUCATION: HS Diploma or General Education Diploma (GED) CERTIFICATION & LICENSURE: CRC-Certified...

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,...

Penn State Health in Hershey, PA is seeking a medical coder to review health records and electronic reports, using ICD-9-CM, CPT, and HCPCS to code diagnoses, services, and procedures for billable care. This full-time role requires a high school diploma and at least 1 year in Revenue Cycle or enrollment in a coding certification program; certification is preferred. We offer comprehensive benefits and opportunities for growth within a leading health system. #J-18808-Ljbffr

Invest in Your Future and Theirs: Beginning January 1, 2027, eligible full‑time Penn State Health employees receive a 50% Penn State tuition discount for themselves and eligible dependents, including a spouse and children. The discount applies at Penn State University Park, Commonwealth Campuses, World Campus, and Penn College of Technology. Penn State Health - Penn State Health Corporation Location: US:PA: Hershey Work Type: Full Time FTE: 1.00 Shift: Day Hours: 8 SUMMARY OF POSITION: Responsible to review the health record, electronic reports, and other reporting tools to identify conditions treated and the services provided to each patient. Utilize the appropriate coding systems (ICD-9-CM, CPT, HCPCS) to accurately code diagnoses, services, and procedures performed by physicians and other providers performing billable services. MINIMUM QUALIFICATION(S): High school diploma required 1 Year relevant Revenue Cycle or enrolled in an approved coding certification class....

Sign-On Bonus $10,000 sign-on bonus eligible to those that qualify Location: Camp Hill, PA Work Type: Full Time FTE: 0.90 Shift: Varied Night Shift Differential: $5.00/hour Hours: Day/Night rotation; every third weekend Recruiter Contact: Emilee Barwin, ebarwin@pennstatehealth.psu.edu Summary of Position The RN inpatient Nurse assesses patient health problems and needs, develops and implements nursing care plans, and maintains medical records. The inpatient Registered Nurse administers nursing care to ill, injured, convalescent, or disabled patients. The RN may advise patients on health maintenance and disease prevention. The inpatient RN will maintain accurate, detailed reports and records and administer medications to patients while monitoring for reactions and side effects. The RN will monitor, record, and report symptoms or changes in patients’ conditions. Minimum Qualification(s) Currently licensed to practice as a Registered Nurse by state of employment or holds a...

Penn State Health in Hershey, PA is seeking a proactive supervisor to oversee the flow of work in Release of Information, Document Imaging, Word Processing, and the file area of HIS. You will provide oversight, corrective action and mentoring for all front line staff. The role emphasizes leadership in a healthcare setting with a focus on accuracy, compliance, and timely processing of records to support patient care and regulatory requirements. #J-18808-Ljbffr

Penn State Health is seeking a healthcare coder to review patient health records and electronic reports to identify conditions treated and services provided. Use ICD-9-CM, CPT, and HCPCS coding systems for billable services performed by physicians and other providers. Minimum qualifications include a high school diploma and 1 year in Revenue Cycle or enrollment in a coding certification class; preferred candidates have 1 year of coding experience and a CPA-certified coder credential. #J-18808-Ljbffr

Invest in Your Future and Theirs: Beginning January 1, 2027, eligible full-time Penn State Health employees receive a 50% Penn State tuition discount for themselves and eligible dependents, including a spouse and children. The discount applies at Penn State University Park, Commonwealth Campuses, World Campus, and Penn College of Technology. Responsible to review the health record, electronic reports, and other reporting tools to identify conditions treated and the services provided to each patient. Utilize the appropriate coding systems (ICD-9-CM, CPT, HCPCS) to accurately code diagnoses, services, and procedures performed by physicians and other providers performing billable services. MINIMUM QUALIFICATION(S) High school diploma required 1 Year relevant Revenue Cycle or enrolled in an approved coding certification class. PREFERRED QUALIFICATION(S) One year of professional coding experience preferred. Certified Professional Coder or similar certification preferred. WHY PENN...

Note : This is an educational program, not a job. Successful completion of the program does not guarantee employment but will equip you with valuable skills for the healthcare job market. Looking to start a rewarding career path in the healthcare industry? Use Dreambound to find a Medical Billing and Coding program that will prepare you for this high-demand, entry-level role. What does a Medical Billing and Coding Specialist do? A medical billing and coding specialist processes and codes healthcare claims to ensure accurate billing and insurance reimbursement, supporting the financial operations of healthcare facilities. Highlights : • Complete in as short as a few weeks to a few months • Online and in-person options available • Payment plans and financial aid may be available for those who qualify Cost : This program is an educational opportunity that requires a financial investment. Cost varies per partner school, but payment plans and / or financial aid may be available...

Remote Chicago - 550 Van Buren Michigan-Grayling Pennsylvania-Trappe Boro Pennsylvania-East Lampeter Twp Pennsylvania-Skippack Twp Pennsylvania-Bethel Twp (Armstrong) Pennsylvania-North Bethlehem Twp Pennsylvania-South Park Twp Pennsylvania-West Norriton Twp Pennsylvania-West Mifflin Boro Pennsylvania-Wilkinsburg Boro Pennsylvania-Cogan House Twp (Lycoming) Kentucky-Wolfe County Pennsylvania-Reading (Berks) Pennsylvania-Bensalem Twp Pennsylvania-Lower Salford Twp Ohio-Mentor Michigan-Lansing Pennsylvania-Clarks Green Boro Ohio-Lima Pennsylvania-Bethlehem Twp Pennsylvania-West Cornwall Twp (Lebanon) Pennsylvania-Edgeworth Boro Ohio-Rocky River Kentucky-Murray Pennsylvania-Kennedy Twp Pennsylvania-Moon Twp Ohio-Bay Village Ohio-Lakewood Ohio-Ashville Kentucky-Lakeside Park Pennsylvania-Lower Paxton Twp Ohio-Oxford Ohio-Bedford Pennsylvania-Ross Twp Pennsylvania-Newtown Twp Pennsylvania-Washington Twp...

Capstone-Logistics, LL is seeking a detail-oriented Quality Auditor to ensure inbound loads meet established standards and to identify any deviations on arrival. The role involves observing load quality, reviewing loads for violations, documenting root causes through tablet procedures, and communicating violations by collecting up to 30 photographs from multiple angles. The candidate will validate information before reporting violations. #J-18808-Ljbffr

Note : This is an educational program, not a job. Successful completion of the program does not guarantee employment but will equip you with valuable skills for the healthcare job market. Looking to start a rewarding career path in the healthcare industry? Use Dreambound to find a Medical Billing and Coding program that will prepare you for this high-demand, entry-level role. What does a Medical Billing and Coding Specialist do? A medical billing and coding specialist processes and codes healthcare claims to ensure accurate billing and insurance reimbursement, supporting the financial operations of healthcare facilities. Highlights : • Complete in as short as a few weeks to a few months • Online and in-person options available • Payment plans and financial aid may be available for those who qualify Cost : This program is an educational opportunity that requires a financial investment. Cost varies per partner school, but payment plans and / or financial aid may be available...

Note : This is an educational program, not a job. Successful completion of the program does not guarantee employment but will equip you with valuable skills for the healthcare job market. Looking to start a rewarding career path in the healthcare industry? Use Dreambound to find a Medical Billing and Coding program that will prepare you for this high-demand, entry-level role. What does a Medical Billing and Coding Specialist do? A medical billing and coding specialist processes and codes healthcare claims to ensure accurate billing and insurance reimbursement, supporting the financial operations of healthcare facilities. Highlights : • Complete in as short as a few weeks to a few months • Online and in-person options available • Payment plans and financial aid may be available for those who qualify Cost : This program is an educational opportunity that requires a financial investment. Cost varies per partner school, but payment plans and / or financial aid may be available...

Remote Chicago - 550 Van Buren Michigan-Grayling Pennsylvania-Trappe Boro Pennsylvania-East Lampeter Twp Pennsylvania-Skippack Twp Pennsylvania-Bethel Twp (Armstrong) Pennsylvania-North Bethlehem Twp Pennsylvania-South Park Twp Pennsylvania-West Norriton Twp Pennsylvania-West Mifflin Boro Pennsylvania-Wilkinsburg Boro Pennsylvania-Cogan House Twp (Lycoming) Kentucky-Wolfe County Pennsylvania-Reading (Berks) Pennsylvania-Bensalem Twp Pennsylvania-Lower Salford Twp Ohio-Mentor Michigan-Lansing Pennsylvania-Clarks Green Boro Ohio-Lima Pennsylvania-Bethlehem Twp Pennsylvania-West Cornwall Twp (Lebanon) Pennsylvania-Edgeworth Boro Ohio-Rocky River Kentucky-Murray Pennsylvania-Kennedy Twp Pennsylvania-Moon Twp Ohio-Bay Village Ohio-Lakewood Ohio-Ashville Kentucky-Lakeside Park Pennsylvania-Lower Paxton Twp Ohio-Oxford Ohio-Bedford Pennsylvania-Ross Twp Pennsylvania-Newtown Twp Pennsylvania-Washington Twp...

Job TitleRevenue Cycle PositionJob DescriptionCollects, reviews, retrieves and codes data by careful review and analysis of documentation of inpatient medical records, assigning the appropriate ICD-10 codes for the purposes of compliance with regulations, statistical compilation, clinical research, clinical care analysis, provider profiling and optimal reimbursement.ResponsibilitiesDuties and Responsibilities Essential Functions:Reviews entire current electronic medical record for pertinent diagnoses and procedures.Assigns diagnoses and procedure codes on inpatient records in accordance with established organization guidelines.Uses ICD-10 CM and PCS coding methodologies following Official Guidelines for Coding and Reporting using encoding software.Queries physicians to clarify documentation needed for coding purposes per established departmental policy.Performs abstraction of clinical and demographic data as pertinent to the account requirements.Participates in documentation...

Remote Chicago - 550 Van Buren Michigan-Grayling Pennsylvania-Trappe Boro Pennsylvania-East Lampeter Twp Pennsylvania-Skippack Twp Pennsylvania-Bethel Twp (Armstrong) Pennsylvania-North Bethlehem Twp Pennsylvania-South Park Twp Pennsylvania-West Norriton Twp Pennsylvania-West Mifflin Boro Pennsylvania-Wilkinsburg Boro Pennsylvania-Cogan House Twp (Lycoming) Kentucky-Wolfe County Pennsylvania-Reading (Berks) Pennsylvania-Bensalem Twp Pennsylvania-Lower Salford Twp Ohio-Mentor Michigan-Lansing Pennsylvania-Clarks Green Boro Ohio-Lima Pennsylvania-Bethlehem Twp Pennsylvania-West Cornwall Twp (Lebanon) Pennsylvania-Edgeworth Boro Ohio-Rocky River Kentucky-Murray Pennsylvania-Kennedy Twp Pennsylvania-Moon Twp Ohio-Bay Village Ohio-Lakewood Ohio-Ashville Kentucky-Lakeside Park Pennsylvania-Lower Paxton Twp Ohio-Oxford Ohio-Bedford Pennsylvania-Ross Twp Pennsylvania-Newtown Twp Pennsylvania-Washington Twp...

Note : This is an educational program, not a job. Successful completion of the program does not guarantee employment but will equip you with valuable skills for the healthcare job market. Looking to start a rewarding career path in the healthcare industry? Use Dreambound to find a Medical Billing and Coding program that will prepare you for this high-demand, entry-level role. What does a Medical Billing and Coding Specialist do? A medical billing and coding specialist processes and codes healthcare claims to ensure accurate billing and insurance reimbursement, supporting the financial operations of healthcare facilities. Highlights : • Complete in as short as a few weeks to a few months • Online and in-person options available • Payment plans and financial aid may be available for those who qualify Cost : This program is an educational opportunity that requires a financial investment. Cost varies per partner school, but payment plans and / or financial aid may be available...

Medical Coding Specialist ICON plc is a world-leading healthcare intelligence and clinical research organization. We're proud to foster an inclusive environment driving innovation and excellence, and we welcome you to join us on our mission to shape the future of clinical development. As a Medical Coding Specialist II at ICON, you will be responsible for advanced coding of medical data within clinical trials, ensuring accurate classification and consistency across studies. What You Will Do: Your role will involve delivering scientific operations work to a high standard, working closely with your team and stakeholders. Key responsibilities include: Performing advanced medical coding of diagnoses, procedures, and medications using standard coding systems such as MedDRA and WHO Drug. Ensuring coding accuracy, consistency, and compliance with regulatory requirements across multiple clinical studies. Collaborating with clinical and data management teams to resolve complex coding...