49 jobs found in Pennsylvania

Amtex Systems Inc is an information technology and talent solutions company offering talent and BI consulting to the companies in US for over 20 years. Our solutions are designed to fill resource gaps, by providing the right candidates who deliver value to the organization. Our propensity to nurture and build strong relationships with our clients helps us better understand their business demands and gives us the ability to provide services that are on time and rise above the rest. We are urgently looking for Rx Claim coders for one of our healthcare client. Multiple positions open 100% REMOTE Must have experience Rx claims experience in most recent project Responsibilities Responsible for adjudicating all CoPay Assist Rx claims electronically. Responsible for adjudicating all Rx claims and billing. Build, maintain, and audit benefits in RxClaim Automated and manual testing using RxClaim Run patient Rx claim to get paid, and contact them for co-pay amount RXCLAIM And...

This position starts out onsite for the first 60-90 days and then will go remote reporting onsite one day a month! Insight Global is seeking a Billing Supervisor to support a large heathcare customer in Atlanta, GA. This individual is responsible for coordinating and supervises the billing and government follow-up functions for all hospital facilities in the system. Oversee a team of 18 individuals. Ensures daily billing of hospital revenue and accuracy and quality of billing activities. Works with hospital departments such as Admissions, Data Processing, Medical Records, ancillary areas, and patient care departments to monitor issues with account registration, charging, and coding to ensure efficiency in the patient account process. This supervisor will be hands on and required to step into the bill when needed. The individual needs to be strong with reporting and looking for trends! Qualifications: Associate degree preferably Bachelor degree 3+ years of...

PRIMARY FUNCTION: Abstract clinical information from Electonic Medical Record surgical reports and outpatient medical records, and assign appropriate ICD-9 and CPT codes.Educating physicians on compliance and correct coding and processing charges,review coding related denials. ESSENTIAL FUNCTIONS: Interacts with co-workers, visitors, and other staff consistent with the Jefferson values Educates new faculty members on the coding basics, as well as all university/department compliance policies Completes all accounts receivable and claims manager edits. Assists patients with billing and insurance related questions. Conducts internal chart audits to ensure compliance with CPT-4 and ICD-10 coding guidelines and determines where additional physician documentation and/or signatures are required. Ensures billing compliance with third party payor requirements and regulations. Qualifications EDUCATIONAL/TRAINING REQUIREMENTS : High School Diploma or...

Maxim Healthcare Staffing is seeking a Billing Specialist. The Billing Specialist will support the organizations accounts receivable process by representing claims for payment to the appropriate payer. Billing Specialists will also perform medical collections and invoicing to patients, providers and medical facilities. Essential Duties and Responsibilities: + Securing payment of open account balances. + Research of rejected payments. + Recommendations for settlement or referral for external collections. + Scheduled invoice printing. + Administrative support to other department operations as needed. + Identifies billing requirements by requesting and obtaining information from the payers. + Completes timely and accurate claim filing in accordance with targeted goals and department policy. + Ensures compliance with established department billing standards by analyzing, auditing, and taking action on unbilled claims. + Resolves reimbursement discrepancies by...

Press Tab to Move to Skip to Content Link Select how often (in days) to receive an alert: Description The MSL is part of a regional therapeutic area MSL team within Field Based Medicine (FBM), who reports into the MSL Sr AD. The focus of this role is field based scientific exchange (SE), for which the MSL will leverage their scientific background, industry knowledge, and business acumen to act as a scientific resource to scientific experts (SCEs), while gathering insights that inform Scientific Objectives (SOs) and strategic decision making by Medicine. Within their territory, MSLs are responsible for establishing, cultivating, and maintaining relationships with SCEs. Further, the MSL functions as an extension of the medical information group to provide product and pipeline therapeutic area expertise to SCEs and HCPs, and as a scientific expert to internal stakeholders within Medicine and Commercial groups at BIPI. The MSL is a collaborative member of BIPI, who is...

**Job Family** **:** General Coding **Travel Required** **:** None **Clearance Required** **:** None Under general supervision, an **Diagnostic Radiology Coder,** codes ED Department charts and procedures and/or charge tickets as assigned. If requested by supervisor, provides technical guidance and training on medical coding to physicians and/or other department staff. Maintains knowledge of AMA guidelines and billing compliance and performs all other duties as required. Must be self-directed / self-motivated; must have good communication and interpersonal skills. Must be: (1) detail oriented (2) accept responsibility for the direction, control and planning of ones own work; (3) recognize the rights and responsibilities of patient and employee confidentiality; (4) adaptable to change and improvement; (5) relate to others in a manner which creates a sense of teamwork and cooperation; (6)show exemplary attitude in levels of maturity, responsibility, judgment...

Job Description Job Description Benefits/Perks Flexible Scheduling Competitive Compensation Careers Advancement  Job Summary We are seeking a Medical Coder to join our team. In this role, you will transcribe patient records and process claims for reimbursements. You will be responsible for selecting the correct codes and functions to be assigned to each instance. The ideal candidate is detail-oriented with strong people skills and computer skills. Responsibilities  Account for coding and abstracting of patient medical appointments Research and analyze data needs for reimbursement Ensure codes are properly sequenced  Analyze, file, and process medical records Keep detailed documentation of any deficiencies or issues with medical records Provide education and training to other coding staff Review and verify documentation  Qualifications High school diploma/GED or equivalent Previous experience as a Medical Coder or in a similar position Familiar with...

Description: Responsible for coordinating and managing the workflow and activities related to processing of Medical Records including chart retrieval, chart prep including thinned charts, loose work and fetal monitors, birth registry, front desk receptionist functions, death process, incomplete chart control, release of information, point of care scanning, faxing discharge instruction to primary care physicians, imaged record management, offsite record storage, second shift, weekend and holiday coverage. Education High School Diploma or Equivalent (Required) Experience 3 Years experience in medical records (Required) 2 Years experience in a supervisory role (Preferred) _

Job Description Summary This position is responsible for overseeing the applicant and return donor reception and registration processes. •Supervise reception and medical staff. •Assist management with daily center operations to include development of reception and medical staff, assessment and improvement of processes, troubleshooting issues and managing donor flow. Job Description Main Responsibilities 1. In compliance with Standard Operating Procedures (SOPs), supervise daily activities of reception, medical, and customer service operations. Provide clear and consistent instructions and directions, conduct meetings, and clearly communicate performance expectations. May be required to perform tasks in work areas. Advise management of employee relation issues or escalated donor issues. 2. In conjunction with other management and supervisory staff, facilitate donor movement throughout the center minimizing donor wait time and processing. 3. Supervise reception and medical...

ROLE SUMMARY The clinician medical monitor may contribute towards providing medical and scientific expertise and oversight for Clinical Trials of pneumococcal vaccines or other vaccine programs. The clinician medical monitor may be required to design a development strategy for multiple protocols designed to obtain worldwide approval for a compound or group of compounds. ROLE RESPONSIBILITIES Accountable for safety across the study: Provide study team with medical advice for all medical issues during risk assessment and mitigation planning to enable quality, compliance and patient safety at the trial, site and patient level. Ensures development of and adherence to the Safety Surveillance Review Plan (SSRP).Consistent with the SSRP, performs and documents regular review of individual subject safety data, and performs review of cumulative safety data with the safety risk lead. As appropriate, the clinician medical monitor may delegate these responsibilities...

At Eisai, satisfying unmet medical needs and increasing the benefits healthcare provides to patients, their families, and caregivers is Eisai's human health care (hhc) mission. We're a growing pharmaceutical company that is breaking through in neurology and oncology, with a strong emphasis on research and development. Our history includes the development of many innovative medicines, notably the discovery of the world's most widely-used treatment for Alzheimer's disease. As we continue to expand, we are seeking highly-motivated individuals who want to work in a fast-paced environment and make a difference. If this is your profile, we want to hear from you. The Associate Director (AD), Alzheimer's disease MSLs is responsible for the leadership, direction and management of the MSLs within their region. This includes providing overall guidance and direction to the MSLs to gain an understanding of the scientific landscape from KOLs/HCPs and communicate the information to key internal...

Job Description Job Description This is a part-time position with flexible options for 26-30 hours per week Monday thru Friday. The successful candidate will be responsible for reviewing and processing insurance authorizations and claims while performing other tasks that ensure maximum reimbursement for the company's services. Qualifications: · Excellent written, phone and verbal communication skills · In-depth knowledge of insurance policies, patient eligibility and benefits · Solid understanding of billing software and Electronic Medical Records · Experience with chart review for all processes from Authorization through Appeals · Understand DMEPOS Fee Schedules for Medicare and PA Medicaid · Accountable to others · Team mentality · Outstanding problem-solving and organizational skills · Attention to detailed tasks and deadlines · Adaptable · Data analysis skills · Minimum of 2 years of experience as medical biller or similar role   Duties: · Chart review to...

Job Description Summary This position is responsible for overseeing the applicant and return donor reception and registration processes. • Supervise reception and medical staff. • Assist management with daily center operations to include development of reception and medical staff, assessment and improvement of processes, troubleshooting issues and managing donor flow. Job Description Main Responsibilities In compliance with Standard Operating Procedures (SOPs), supervise daily activities of reception, medical, and customer service operations. Provide clear and consistent instructions and directions, conduct meetings, and clearly communicate performance expectations. May be required to perform tasks in work areas. Advise management of employee relation issues or escalated donor issues. In conjunction with other management and supervisory staff, facilitate donor movement throughout the center minimizing donor wait time and processing. Supervise reception and medical work...

Job Description Summary This position is responsible for overseeing the applicant and return donor reception and registration processes. • Supervise reception and medical staff. • Assist management with daily center operations to include development of reception and medical staff, assessment and improvement of processes, troubleshooting issues and managing donor flow. Job Description Main Responsibilities 1. In compliance with Standard Operating Procedures (SOPs), supervise daily activities of reception, medical, and customer service operations. Provide clear and consistent instructions and directions, conduct meetings, and clearly communicate performance expectations. May be required to perform tasks in work areas. Advise management of employee relation issues or escalated donor issues. 2. In conjunction with other management and supervisory staff, facilitate donor movement throughout the center minimizing donor wait time and processing. 3. Supervise reception and medical work...

Job Description Job Description Must have at least 3-5 years related work exprience   Benefits 401(k) matching Dental insurance Employee discount Health insurance Life insurance Paid time off Vision insurance Show fewer   A team player with excellent customer service skills to provide a full range of insurance processing and data analysis duties in support of efficient operations. To perform services necessary to complete efficient insurance processing for all payor classes. Skills: Knowledge of medical terminology with insurance experience required. Must be detail oriented, well organized with speed and accuracy. Knowledge of computers is mandatory along with excellent organizational skills. Excellent telephone etiquette required. PRINICPAL ACCOUNTABILITIES: Essential Functions Establishes timely contact with patients for registration in the electronic health record and processing of insurance information. Coordinates team to schedule new patient...

Job Description Job Description Nurse Medical Auditor  (Provider Reimbursement and Payment Methodologies)  (Hybrid or Remote)  Philadelphia, PA    Homestead Smart Health Plans , located in Philadelphia, PA, has an immediate full-time, permanent opening available for a Nurse Medical Auditor who is experienced with Medical Billing, Coding and Auditing of Health Insurance Claims.    Position Overview:  This position is responsible for the review and auditing of medical health plan claims received from providers and facilities for medical necessity and billing accuracy.   The position is responsible for viewing patient records, itemized billing statements, and related medical claims.   References used are Usual and Customary Averages, CMS billing practices and Guidelines, and American Hospital Directory data.   After review, the results are applied to a detailed Audit Report of the claim that is then sent to the Third-Party Administrator for processing and...

**Job Family** **:** General Coding **Travel Required** **:** None **Clearance Required** **:** None **What You Will Do** **:** **The General Surgery Coder** must be proficient in surgical coding for all Trauma Surgery type cases. E/M experience is also required for associated providers. The coder will review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10 Diagnosis codes, along with CPT/HCPCS codes as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance. Under the direction of the coding managerthe coder should accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting, CMS/MAC rules and the CPT rules established by the AMA, and any other official coding guidelines established for use with mandated standard code sets. The coder scope may involve...

Job Description Job Description Nurse Medical Auditor (Provider Reimbursement and Payment Methodologies) (Hybrid or Remote) Philadelphia, PA Homestead Smart Health Plans, located in Philadelphia, PA, has a new and immediate full-time, permanent opening available for a Nurse Medical Auditor who is experienced with Medical Billing, Coding and Auditing of Health Insurance Claims. Position Overview This position is responsible for the review and auditing of medical health plan claims received from providers and facilities for medical necessity and billing accuracy. The position is responsible for viewing patient records, itemized billing statements, and related medical claims. References used are Usual and Customary Averages, CMS billing practices and Guidelines, and American Hospital Directory data. After review, the results are applied to a detailed Audit Report of the claim that is then sent to the Third-Party...

Job Description Job Description Enjoy what you do while contributing to a company that makes a difference in people’s lives. Shady Grove Fertility, one of the premier fertility centers in the United States, continually seeks experienced, compassionate, and dynamic team players who are committed to delivering exceptional patient care to join our growing practice. The work we do building families offers stimulation, challenge, and personal reward. If you're a Office Supervisor looking for a new opportunity to work in a fast-paced, professional environment where your talent contributes to changing people’s lives, then we want to talk to you. This position requires collaborating with physicians, other medical providers, and patients by providing expert care and service for fertility treatments. We are currently seeking candidates for a full-time Office Supervisor position to work in our Center City and Newark, DE offices. The schedule is working Monday through Friday, 8:00AM...

Job Description Summary This position is responsible for overseeing the applicant and return donor reception and registration processes. • Supervise reception and medical staff. • Assist management with daily center operations to include development of reception and medical staff, assessment and improvement of processes, troubleshooting issues and managing donor flow. Job Description Main Responsibilities 1. In compliance with Standard Operating Procedures (SOPs), supervise daily activities of reception, medical, and customer service operations. Provide clear and consistent instructions and directions, conduct meetings, and clearly communicate performance expectations. May be required to perform tasks in work areas. Advise management of employee relation issues or escalated donor issues. 2. In conjunction with other management and supervisory staff, facilitate donor movement throughout the center minimizing donor wait time and processing. 3. Supervise reception and medical work...