133 jobs found in Pennsylvania

Medical Coding Specialist Overview The Medical Coding Specialist will ensure accurate risk adjustment coding for Medicare plans. Collaborate with healthcare providers to address documentation gaps and enhance coding accuracy. Conduct audits and quality control checks on coding outputs for compliance with HCC/ICD-10-CM guidelines. Serve as a senior-level resource, providing second-level reviews and addressing complex coding issues. Educate providers on documentation practices to support accurate risk adjustment coding. Track error patterns and trends in coding quality, reporting findings to improve processes. Work independently to ensure compliance with CMS risk adjustment guidelines and RAF methodology. Support the organization’s mission to provide exceptional care to members through accurate coding practices. Medical Coding Specialist Key Responsibilities & Duties Audit coding team outputs for accuracy and compliance with HCC/ICD-10-CM guidelines. Review disposition...

Greenkey Resources LLC seeks a Medical Coding Specialist to ensure accurate risk adjustment coding for Medicare plans and to collaborate with providers on documentation improvements. You will conduct audits for HCC/ICD-10-CM compliance, serve as a senior resource for complex coding issues, and educate providers on documentation practices to support RAF methodology. Independent work and proactive problem-solving are essential. #J-18808-Ljbffr

Medical Coding Specialist Overview The Medical Coding Specialist will ensure accurate risk adjustment coding for Medicare plans. Collaborate with healthcare providers to address documentation gaps and enhance coding accuracy. Conduct audits and quality control checks on coding outputs for compliance with HCC/ICD-10-CM guidelines. Serve as a senior-level resource, providing second-level reviews and addressing complex coding issues. Educate providers on documentation practices to support accurate risk adjustment coding. Track error patterns and trends in coding quality, reporting findings to improve processes. Work independently to ensure compliance with CMS risk adjustment guidelines and RAF methodology. Support the organization’s mission to provide exceptional care to members through accurate coding practices. Medical Coding Specialist Key Responsibilities & Duties Audit coding team outputs for accuracy and compliance with HCC/ICD-10-CM guidelines. Review disposition...

Greenkey Resources LLC seeks a Medical Coding Specialist to ensure accurate risk adjustment coding for Medicare plans and to collaborate with providers on documentation improvements. You will conduct audits for HCC/ICD-10-CM compliance, serve as a senior resource for complex coding issues, and educate providers on documentation practices to support RAF methodology. Independent work and proactive problem-solving are essential. #J-18808-Ljbffr

Job Title Medical Coding Specialist Job Description Collects, reviews, retrieves and codes Evaluation & Management codes, and major procedures (surgical procedures, anesthesia reports, radiology reports/procedures) and other services for Medicine/Surgical practices, based on data from medical documentation and reports for quality assessment, audit, and billing purposes. Responsibilities Duties and Responsibilities Essential Functions: Performs chart audits, reviewing for accuracy and compliance. Reviews operative reports and other documentation and assigns appropriate diagnosis (ICD-10) procedure codes (CPT), and other items (HCPCS) for final billing. Research and process invoice corrections. Reviews and analyzes coding/billing procedures. Presents training and feedback concerning medical coding, compliance, and reimbursement to physicians/providers. Coordinates and implements reimbursement improvement activities with staff and providers. Adheres to...

Job Title PRN (As Needed) Job Description Monday - Friday Varied Day/Evening Shifts Weekend and holiday rotation Includes cross-training in post-surgical, inpatient rehab, and outpatient settings General Summary Provides occupational therapy services at an entry to intermediate skills level to individual patients according to the principles and practices of occupational therapy. Directs patient participation in selected tasks to restore, reinforce and enhance performance; facilitates the learning of those skills and functions essential for adaptation and productivity. Responsibilities Duties and Responsibilities Essential Functions: Evaluates patient using evidence based evaluation techniques. Plans individualized occupational therapy program with a variety of sensorimotor, educational, recreational and social activities based on the individual's physical capacity, intelligence level, and interests/goals. Provides instructions in therapeutic procedures to be...

General Lab Supervisor Opportunity Join a top healthcare facility in South-Central Pennsylvania as a General Lab Supervisor for permanent, direct hire! Shift: Full-Time, Night hours Type: Permanent/Direct Hire Job Description: Top healthcare facility looking for an experienced and dedicated General Lab Supervisor to join our team. The Lab Supervisor will oversee the daily operations of the General Lab, ensuring compliance with regulatory requirements and maintaining the highest standards of quality and safety. Key responsibilities include: Managing a team of lab technicians and ensuring adequate staffing level Implementing and monitoring quality control procedures Training staff on lab procedures and safety protocols Participating in departmental meetings and contributing to strategic planning initiatives Requirements: Bachelor's degree in Medical Technology, Clinical Laboratory Science, or related field. Certification through ASCP is strongly preferred. Minimum of...

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....

Penn State Health - Hershey Medical Center Location: US:PA: Hershey Work Type: Full Time FTE: 1.00 Shift: Day Hours: Varied 8hr Days Summary Of Position: 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. Assists Manager and Medical...

Job Description Job Description Job Title: Medical Auditor Job Type: Contractor Location: Remote Job Overview We are seeking experienced Medical Auditors to contribute their specialized expertise to an innovative healthcare AI project. In this role, you will help improve next-generation AI systems by reviewing, evaluating, and refining medical coding and audit-related content. This opportunity is ideal for professionals with strong experience in outpatient professional fee coding, auditing, and academic medical center environments. No prior AI experience is required—your healthcare expertise is what matters most. Key Responsibilities Conduct detailed reviews and audits of outpatient professional fee coding records for accuracy, compliance, and quality. Identify coding trends, gaps, risks, and opportunities for improvement. Evaluate audit findings using knowledge of academic medical center protocols and industry best practices. Document audit results and...

St. Luke's St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care. The Physician Coder codes and abstracts physician services performed in the hospital setting according to AHA, AMA, guidelines and CMS directives. Must assure data quality through quarterly reviews. Performs data entry of physician services statistics into specialty-specific databases. Works with Medical Records, Finance, and Physician Billing to ensure appropriate flow of information. Job Duties And Responsibilities: Codes and abstracts professional fee hospital services...

Medical Billing Specialist (Revenue Cycle Management) – Bilingual Spanish Preferred This is not a Remote position; it is in the Office Monday - Friday. This is not an entry-level role and requires independent ownership of revenue cycle processes. Position Summary Reliant Healthcare Group is seeking an experienced Medical Billing Specialist with demonstrated Revenue Cycle Management (RCM) expertise. This role is responsible for managing AR, payer follow-ups, and claim resolution to ensure timely reimbursement. Essential Duties & Responsibilities Manage full Revenue Cycle Management (RCM) processes Verify insurance eligibility and benefits for commercial and Medicaid MCO payers Follow up on Accounts Receivable exceeding 30 days Review AR aging reports and resolve outstanding balances Post payments and perform account reconciliations Obtain and manage insurance authorizations Review and correct claims to prevent denials Interpret payer contracts and...

Medical Case Management Supervisor PHMC serves as both a direct service provider to individuals, families, and communities across the region and as an intermediary agent — managing large-scale contracts, government and philanthropic partnerships, and multidisciplinary initiatives that require operational sophistication, strategic leadership, and deep mission alignment. The Medical Case Management Supervisor shall oversee the staffing and performance of Medical Case Managers (MCM) and HIV/PrEP Patient Navigators across the PHMC Health Network. This person shall possess a strong knowledge of the Philadelphia Division of HIV Health (DHH) Medical Case Management and PrEP standards and shall serve as a liaison to DHH around MCM activities. The Medical Case Manager Supervisor will ensure that regular, ongoing, and high-quality supervision is provided and appropriately documented, and that all staff are connected to and complete all required trainings. The Medical Case Manager...

UPMC Corporate Revenue Cycle is hiring a Coder I- Profee to join our Coding Department! This will be a work-from-home position working Monday through Friday during business hours. In this role, you will assign ICD and limited CPT codes. Coders review the physician documentation to determine the appropriate ICD-10 code and verify the CPT code, but in some cases assign basic CPT codes. Resolve basic coding edits. Complete the charging process. Ensure diagnosis codes meet local medical necessity guidelines for ancillary tests that were ordered-- requires knowledge of billing and coding guidelines. Utilize coding resources (CCI edits, 3M, ICD and CPT Publications) along with any other applicable specialty reference material to ensure accurate coding. Responsibilities: Utilize standard coding guidelines and principles and coding clinics to assign the appropriate ICD and CPT for all records to ensure accurate reimbursement. Review coding for accuracy and completeness prior to...

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. This position will be working on inpatient codes. As the Coder II, 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...

Medical Billing Specialist SPECIFIC RESPONSIBILITIES: Generate primary and secondary paper bills according to established procedures. Edit paper claims before mailing. Perform claim follow up on denials quickly and accurately from assigned payers to ensure revenues are received timely. Run 837 files according to established procedures. Resolve any validation issues Accurate and timely data entry into payer websites for original claim submissions and/or corrected claims submissions. Verify and post remittance from assigned payers. Re-bill accounts as necessary to ensure an open insurance receivable against which a payment can be applied. Thoroughly research questionable/unidentified payment in order to post properly or refund to payer per payer guidelines. Work with payers and subscribers to resolve issues and facilitate prompt payment of claims. Verify NAP issues and work to resolve. Identify and communicate to up-line delays effecting balancing issues, new codes, or adjustments....

Heritage-Valley-Health-System in Beaver County, United States seeks an Accounts Receivable specialist to verify insurance, prepare patient accounts for billing, and conduct timely follow-up to resolve questions. The role requires strong Excel skills and knowledge of CPT/HCPCS/ICD-10-CM coding. You will pull monthly Aged Trial Balance reports in Excel and drill down to your area of responsibility to facilitate timely billing and follow up. #J-18808-Ljbffr

ENT & Allergy Specialist of Western PA in Sewickley, PA is seeking a Medical Billing & Coding Specialist for our busy Otolaryngology & Allergy Practice. This is an immediate full-time opening in our Sewickley office, Monday through Friday daylight hours. Must have knowledge of CPT and ICD-10 coding, insurance verification, billing, posting charges and payments, understanding EOBs, and collecting co-pays and deductibles. #J-18808-Ljbffr

UPMC Corporate Revenue Cycle is hiring a Coder I- Technical to join our Emergency Department coding team! This position will work during daylight business hours, Monday through Friday. As the Coder I, you will code Ancillary outpatient accounts, diagnosis coding only. You will code ancillary service patient type (single visit service such as lab, x-ray, pathology specimen). The Coder I reviews the physician script, order, or chief complaint as documented in a diagnostic report to determine the appropriate ICD-10 code. You will ensure that diagnosis codes meet local medical necessity guidelines for ancillary tests that were ordered. Responsibilities: Refer problem accounts to appropriate coding or management personnel for resolution. Meet appropriate coding productivity and quality standards within the time frame established by management staff. Adhere to internal department policies and procedures to ensure efficient work processes. Actively participate in monthly...

Remote Medical Biller & Coder Rooted Talent Solutions is actively seeking remote medical billers and coders to join our healthcare support team. This is a remote, independent contractor opportunity involving medical claim processing, coding, and administrative support for healthcare providers. We're hiring both experienced professionals and motivated individuals looking to enter the field. If you're detail-oriented, organized, and eager to work from home, this could be the right opportunity for you. Responsibilities Process and submit medical claims accurately and on time Assign appropriate ICD-10, CPT, and HCPCS codes Review documentation for coding compliance Follow up on denied or unpaid claims as needed Communicate with providers, payers, or clients when necessary Maintain HIPAA compliance and data security standards Qualifications Preferred: Experience with medical billing, coding, or claim processing Familiarity with EHR or billing software Strong...