NewClaims and Denial Coding Analyst St. Luke's Health Network, Inc.Claims and Denial Coding AnalystAllentown, PAFull timeIndividually 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 Claim and Denial Coding Analyst role is a Certified Medical Coder who ensures clean claim submission and timely review and resolution of coding related claim denials for professional services, FQHC, MSO, and ASCs across the network.
NewPrior Authorization Specialist Oxford Solutions, IncPrior Authorization SpecialistPittsburgh, PA$18–$21 / hourContractorIn this role, you will help patients gain timely access to needed medications by processing prior authorizations and insurance verifications quickly and accurately. Oxford Solutions is seeking a Pharmacy Prior Authorization Specialist to join a growing pharmacy support team in Pittsburgh.
Accounts Receivable Specialist-Physician Billing St. Luke's Health Network, Inc.Accounts Receivable Specialist-Physician BillingAllentown, PAFull timeIndividually 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. Process all UB04 and HCFA-1500 claims through the related billing system, working the related claims scrubber in a timely and efficient manner; performs all associated duties in order to ensure the completeness and accuracy of all claim information, facilitating maximum reimbursement.
Accounts Receivable Specialist- Correspondence (On Site) St. Luke's Health Network, Inc.Accounts Receivable Specialist- Correspondence (On Site)Allentown, PAFull timeIndividually 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. Process all UB04 and HCFA-1500 claims through the related billing system, working the related claims scrubber in a timely and efficient manner; performs all associated duties in order to ensure the completeness and accuracy of all claim information, facilitating maximum reimbursement.
Accounts Receivable Specialist- Physician Billing St. Luke's Health Network, Inc.Accounts Receivable Specialist- Physician BillingAllentown, PAFull timeIndividually 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. Process all UB04 and HCFA-1500 claims through the related billing system, working the related claims scrubber in a timely and efficient manner; performs all associated duties in order to ensure the completeness and accuracy of all claim information, facilitating maximum reimbursement.
Accounts Receivable Specialist- Hospital Billing St. Luke's Health Network, Inc.Accounts Receivable Specialist- Hospital BillingAllentown, PAFull timeIndividually 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. Process all UB04 and HCFA-1500 claims through the related billing system, working the related claims scrubber in a timely and efficient manner; performs all associated duties in order to ensure the completeness and accuracy of all claim information, facilitating maximum reimbursement.
Digital Content Specialist III Pinnacle Technical ResourcesDigital Content Specialist IIIPennsylvania$50–$60 / hourContractorThe specific compensation for this position will be determined by several factors, including the scope, complexity, and location of the role, as well as the cost of labor in the market; the skills, education, training, credentials, and experience of the candidate; and other conditions of employment. Responsibilities include supporting content operations, quality assurance, accessibility, governance, and continuous improvement to ensure content is consistent, discoverable, and aligned with customer needs and business goals.
Mid-level Project Controls Specialist Pinnacle Technical ResourcesMid-level Project Controls SpecialistAllentown,, Pennsylvania$35–$40 / hourContractorThe Mid-level Project Controls Specialist will play a critical role in supporting project management teams by providing expertise in project planning, scheduling, cost control, and reporting. The specific compensation for this position will be determined by several factors, including the scope, complexity, and location of the role, as well as the cost of labor in the market; the skills, education, training, credentials, and experience of the candidate; and other conditions of employment.
Coding Appeals Specialist St. Luke's Health Network, Inc.Coding Appeals SpecialistAllentown, PAPart timeThe Coding Appeals Specialist analyzes patient medical records, claims data and coding on all diagnosis and procedure codes to assure properly assigned MS-DRG for the purposes of appealing proposed MS-DRG and coding changes by insurance providers or their auditors. Identify and provide feedback, including identification of trends, to the Network Coding and CDMP Managers for education of the medical staff, clinical documentation professionals and the coding professionals on documentation issues that affect proper documentation and coding of documented medical care for appropriate reimbursement.
NewSpecialist, Finance Liberty CokeSpecialist, FinancePhiladelphia, PAThis position assists the Shared Service record-to-report team with the monthly SAP close process and consolidated financial reporting for the purpose of maintaining an effective accounting system to optimize spending and improve overall profitability. Additionally, the candidate will possess: Bachelor's degree in accounting, finance, business management is required; Advanced degrees or certifications (MBA, CPA, CMA) are welcome and can accelerate growth, but are not required.
Practice Prior Auth and Referral Specialist - Sleep Medicine St. Luke's Health Network, Inc.Practice Prior Auth and Referral Specialist - Sleep MedicineBethlehem, PAFull timeIndividually 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. Responds to written as well as telephone inquires from patients, insurances, pharmacies, other outpatient/inpatient departments, and facilities regarding planned specialty care and/or services.
Practice Prior Authorization Specialist, ENT and Allergy St. Luke's Health Network, Inc.Practice Prior Authorization Specialist, ENT and AllergyBethlehem, PAFull timeIndividually 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. Responds to written as well as telephone inquires from patients, insurances, pharmacies, other outpatient/inpatient departments, and facilities regarding planned specialty care and/or services.
Provider Enrollment Specialist St. Luke's Health Network, Inc.Provider Enrollment SpecialistAllentown, PAFull timeIndividually 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 Provider Enrollment Specialist ensures that initial and re-credentialing applications for St. Luke’s University Health Network (SLUHN) employed providers’ are submitted to identified third party and government health insurance carriers.
Accounts Receivable Coordinator St. Luke's Health Network, Inc.Accounts Receivable CoordinatorAllentown, PAFull timeResponsible for training and coordination of the activities related to third party claim form formats, claim “scrubbing,” claim submission and claims editing to ensure optimal reimbursement and maximization of cash flow, timely follow-up, denials resolution, payment posting and processing of all related correspondence. 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.
Casualty Claims Specialist First Chicago Insurance CompanyCasualty Claims SpecialistPhiladelphia, PAThey will settle complex liability claims which require greater investigation and verification, as well as casualty claims including severe injuries which may result in extended disability or bodily injury as well as coverage related litigation. The Casualty Claims Specialist will have the following duties and responsibilities: Review & determine course of action on each file assigned, utilizing technical knowledge & experience for the purpose of supporting final disposition of a loss.
Casualty Claims Specialist First Chicago Insurance Company (FCIC)Casualty Claims SpecialistErie, PAFull timeThey will settle complex liability claims which require greater investigation and verification, as well as casualty claims including severe injuries which may result in extended disability or bodily injury as well as coverage related litigation. The Casualty Claims Specialist will have the following duties and responsibilities:Review & determine course of action on each file assigned, utilizing technical knowledge & experience for the purpose of supporting final disposition of a loss.
Workers Compensation Claims Specialist Healthcare Services Group, Inc.Workers Compensation Claims SpecialistBensalem, PennsylvaniaThe Workers’ Compensation Claims Specialist will support the Department by operating as a liaison between HCSG and claims organizations (WC Carriers and/or TPAs), ensuring timely and appropriate action and managing related processes. The Risk Management Department protects the financial and reputational integrity of the Company by aggressively mitigating and managing known risks and proactively identifying and planning for future risks.
Senior Claims Specialist CorVel Enterprise Claims, Inc.Senior Claims SpecialistNorristown, PA$61,053–$98,334 / yearPart timePay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries.
Claims Specialist - Property Philadelphia Insurance CompaniesClaims Specialist - PropertyBala Cynwyd, PA$84,422–$99,320 / yearEvaluates each claim in light of facts; Affirm or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner. Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries.
NewClaims Specialist Supervisor (Hybrid) First AmericanClaims Specialist Supervisor (Hybrid)Berwyn, PennsylvaniaThe Supervisor serves as an escalation point for Claims Specialists and partners with Claims Counsel and Claims leadership to appropriately identify and escalate claims involving significant complexity, legal issues, increased exposure, or matters outside established authority. The Claims Specialist Supervisor is responsible for leading a team of Claims Specialists and/or Claims Coordinators who investigate, evaluate, and resolve assigned title insurance claims within established levels of complexity and authority.