Professional Coding Specialist III - Cardiothoracic Surgery West Virginia University MedicineProfessional Coding Specialist III - Cardiothoracic SurgeryPAAccurately codes and/or audits complex surgical procedures as part of daily workload (85%-95% of workload) including but not limited to: Bariatric surgery, Cardiothoracic surgery, Gynecologic surgery, Oncology surgery, Orthopaedics surgery, Thoracic surgery, Transplant surgery, Trauma and burn surgery, and Open Vascular surgery. Reviews and accurately interprets medical record documentation from all accounts in order to identify all diagnosis and procedures that affect the current inpatient stay or outpatient encounter and assigns the appropriate ICD-10, CPT, or modifier codes for each diagnosis and procedure that is identified.
Manager Clinical Performance & Quality Coding (Nurse Practitioner or PA) Elevance Health IncManager Clinical Performance & Quality Coding (Nurse Practitioner or PA)seven fields, PADevelop and manage clinical quality reviews to ensure peer review and clinical quality chart audit process including targeting chart reviews, auditing percentages, score guidelines feedback mechanism and ensure compliance with remediation procedures. Requires a master's in Nursing (or PA equivalent) and at least 3 years of clinical experience in applying appropriate diagnosis in the Medicare HCC Mode; or any combination of education and experience, which would provide an equivalent background.
Manager Clinical Performance & Quality Coding (Nurse Practitioner Or PA) Elevance HealthManager Clinical Performance & Quality Coding (Nurse Practitioner Or PA)Seven Fields, PADevelop and manage clinical quality reviews to ensure peer review and clinical quality chart audit process including targeting chart reviews, auditing percentages, score guidelines feedback mechanism and ensure compliance with remediation procedures. Requires a master's in Nursing (or PA equivalent) and at least 3 years of clinical experience in applying appropriate diagnosis in the Medicare HCC Mode; or any combination of education and experience, which would provide an equivalent background.
Coding Auditor Senior Highmark IncCoding Auditor SeniorPABachelor's Degree and Registered Health Information Administrator (RHIA) certification or ten (10) years' experience in a medical record setting and one (1) of the following certifications from a certifying body must apply: American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA). In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.
NewSenior Hierarchical Condition Category (HCC) Coding Specialist Highmark IncSenior Hierarchical Condition Category (HCC) Coding SpecialistPAThis job will deliver value to the Health Plan and its beneficiaries enrolled in risk-adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA) through Hierarchical Condition Category (HCC) coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and support of Risk Adjustment Data Validation (RADV) audits. Completes analytics on providers and/or provider group coding trends and creates and delivers externally facing presentations to provider documentation and accuracy, acts as the point person for the provider office for any questions and additional trainings, as needed.20%.
Hierarchical Condition Category (HCC) Coding Specialist Highmark IncHierarchical Condition Category (HCC) Coding SpecialistPAThis job will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA), using skills including but not limited to Hierarchical Condition Category (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment Data Validation (RADV) Audits. Flexes between coding projects, including Retro and Prospective, with different MA, ESRD, and ACA HCC Models; works independently in various coding applications and electronic medical record systems to support departmental goals.
Epic Resolute Application Developer (Charge Router and Coding Skills) - 6260321 Accenture PlcEpic Resolute Application Developer (Charge Router and Coding Skills) - 6260321Pittsburgh, PAIn addition to delivering innovative solutions for Accenture's clients, you will work with a highly skilled, diverse network of people across Accenture businesses who are using the latest emerging technologies to address today's biggest business challenges. Dropping orders using chart review-> creating new patient encounter -> dropping an order and signing the order/Unite charge entry ->creating new encounter.
Physician Coding Auditor Ensemble Health PartnersPhysician Coding AuditorPittsburgh, PARemote$57,400–$99,000 / yearThe Physician Coding Auditor develops and implements strategic needs analyses and training plans for coding leadership; coordinates and evaluates curriculum development and conducts the preparation and delivery of training for Medical Coders employed by Ensemble and providers that are contracted/employed and outlined in the client SOW. Educating - Assesses the educational needs of coding staff and providers that are contracted/employed and outlined in the client SOW (included Provider Education verbiage) and develops programs or researches educational resources to meet those needs.
Coder II - Technical (Inpatient Coding University of Pittsburgh Medical CenterCoder II - Technical (Inpatient CodingPittsburgh, PARemoteMaintain daily productivity statistics and submit a weekly productivity sheet to management clearly indicating the number of hours worked, the number of coding hours, the number of average charts per hour, and number of minutes/hours spent on non-coding tasks. Completed an AHIMA or AACP-certified Coding program or certificate, Bidwell Training School or equivalent program with a curriculm that includes Anatomy and Physiology, Pharmacology, Pathophysiology, Medical Terminology, ICD-9-CM/ICD-10 and CPT Coding Guidelines and Procedures.
Coder III - Technical (Interventional Radiology and Cardiovascular Coding University of Pittsburgh Medical CenterCoder III - Technical (Interventional Radiology and Cardiovascular CodingPittsburgh, PARemoteMaintain daily productivity statistics and submit a weekly productivity sheet to management clearly indicating the number of hours worked, the number of coding hours, the number of average charts per hour, and number of minutes/hours spent on non-coding tasks. Licensure, Certifications, and Clearances: Certified Coding Specialist (CCS OR Certified Professional Coder (CPC OR Nationally Registered Certified Coding Specialist (NRCCS OR Registered Health Information Administrator OR Registered Health Information Technician (RHIT required.
Senior Software Engineer (Claude Code or Google Gemini) Highmark IncSenior Software Engineer (Claude Code or Google Gemini)PATo include: 5 years in at least one modern programming languages (Java, Python, JavaScript, ACE, IIB/ITX, Informatica preferred), and experience with at least two of the following: React, Angular v4+, NodeJS, NoSQL databases, HTML5, CSS, Google Cloud Platform or Amazon Web Services. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.
Software Engineer Principal - Data and Automation (Sagemaker, AWS CDK, Infrastructure as Code (IaC), Python, Pyspark) The PNC Financial Services Group IncSoftware Engineer Principal - Data and Automation (Sagemaker, AWS CDK, Infrastructure as Code (IaC), Python, Pyspark)Pittsburgh, PAPNC Employees take pride in our reputation and to continue building upon that we expect our employees to be: Customer Focused - Knowledgeable of the values and practices that align customer needs and satisfaction as primary considerations in all business decisions and able to leverage that information in creating customized customer solutions. In addition, PNC generally provides the following paid time off, depending on your eligibility: maternity and/or parental leave; up to 11 paid holidays each year; 9 occasional absence days each year, unless otherwise required by law; between 15 to 25 vacation days each year, depending on career level; and years of service.
Software Engineer Principal - Data and Automation (Sagemaker, AWS CDK, Infrastructure as Code (IaC), Python, Pyspark) PNC BankSoftware Engineer Principal - Data and Automation (Sagemaker, AWS CDK, Infrastructure as Code (IaC), Python, Pyspark)Pittsburgh, PennsylvaniaAmazon SageMaker, Amazon Web Services (AWS), Apache Spark, Application Development, Business Management, Customer Solutions, Design, Group Problem Solving, Process Improvements, Release Management, Software Solutions, User Experience (UX) Design Competencies . PNC Employees take pride in our reputation and to continue building upon that we expect our employees to be: Customer Focused - Knowledgeable of the values and practices that align customer needs and satisfaction as primary considerations in all business decisions and able to leverage that information in creating customized customer solutions.
Entry Level Medical Billing Assistant Revel StaffingEntry Level Medical Billing AssistantPittsburgh, PennsylvaniaThe Medical Billing Assistant will help prepare and review insurance claims, assist with basic billing and coding tasks, update patient and insurance information, and support the administrative workflows that help keep clinical operations running smoothly. This person should be comfortable learning billing and coding processes, communicating with patients professionally, and maintaining accuracy when working with claims, records, and confidential information.
Physician Assistant - Outpatient Domain - Medical Oncology Highmark IncPhysician Assistant - Outpatient Domain - Medical OncologyPittsburgh, PAProvides appropriate patient care to include recording patient medical history and physical assessment, developing therapeutic care plan, ordering diagnostic tests, interpreting test results, discharge planning and providing accurate medical record documentation for patients in physician office(s) and non- acute based settings (20%). In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.
Physician Assistant - Outpatient Domain - Cardiac/Oncology Program Highmark IncPhysician Assistant - Outpatient Domain - Cardiac/Oncology ProgramPittsburgh, PAProvides appropriate patient care to include recording patient medical history and physical assessment, developing therapeutic care plan, ordering diagnostic tests, interpreting test results, discharge planning and providing accurate medical record documentation for patients in physician office(s) and non- acute based settings (20%). In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.
Patient Account & Billing Manager University of PittsburghPatient Account & Billing ManagerPittsburgh, PAIn addition to being a great place to work the University offers robust benefits including: 11 Paid Holidays in addition to paid Vacation, Sick and Personal Days Additional Paid Time Off (Winter Recess) during the period between Christmas and the New Year Paid Parental Leave Education benefits for eligible employees, their dependents and spouse/domestic partner Above-average Employer Contribution towards Medical, Prescription Drug, Vision, Life, STD, and LTD Insurance plans A robust retirement savings plan option, including 100% match on employee contributions of 3-8% (150% after vesting) and enhanced match for those nearing retirement * Free PAT bus pass. This position will be responsible for, but not limited to, the following functions: liaison between the faculty practice and 3rd-party billing agency, ensure accurate claims processing, assist in claim denials and follow ups, timely payment posting, effective resolution of billing and patient account issues, manage provider procedure entries, assist in researching/locating insurance EOBs and initiate and manage outbound calls to patients regarding outstanding balances.
Netsmart EHR RCM Consultant enkompas Technology SolutionsNetsmart EHR RCM ConsultantSewickley, PARemoteRevenue Cycle Management Integration: Ensure Netsmart EHR systems are fully integrated with revenue cycle management processes, from patient registration through billing and collection. Training and Support: Develop training materials and conduct training sessions for healthcare providers, clinical staff, and administrative staff on Netsmart EHR and RCM system usage.
Senior Field Reimbursement Specialist- Cell and Gene Therapy/Rare Disease Cencora IncSenior Field Reimbursement Specialist- Cell and Gene Therapy/Rare DiseasePA$93,500–$187,000 / yearProgressively responsible experience in field reimbursement, patient access, market access, revenue cycle, managed care, provider support, pharmaceutical/biologic support programs, or a related healthcare access role, with demonstrated experience working directly with health systems, hospitals, academic medical centers, authorized treatment centers, and/or large institutional accounts. This role will act as a liaison to patient assistance, reimbursement support, and access services offered by the client, with a focus on helping institutional stakeholders understand product acquisition pathways, CGT-specific prior authorization requirements, site-of-care considerations, coding and billing requirements, denial and appeal processes, and operational logistics that may affect timely access for patients with rare diseases.
Medical Receptionist-Scott Township Preferred Primary Care Physicians, Inc.Medical Receptionist-Scott TownshipPittsburgh, PAFull timeESSENTIAL RESPONSIBILITIES:Greet Patients that arrive according to the established guidelines of the officeCheck-in patients, verify and update all information in electronic medical system and collect co-paymentsCheck-out patients, scheduling necessary appointmentsMaintain computer scheduling in accordance with office protocolAnswer telephones, screen calls, take messages and provide information in accordance with established protocolCollection of payments and proper cash reconciliationProvide clerical support as neededScreen visitors and respond to routine requests for informationCloseout procedures, gathering encounter forms, processing daily activities of coding, batching, billing and hospital visitsQUALIFICATIONS:Education: High school diploma or equivalentExperience/On the Job Training:Minimum six (6) month medical front office experience. GENERAL OVERVIEW:The Medical Receptionist serves as the initial person to greet, instruct and direct all persons visiting or calling the medical practice utilizing skills of tact, diplomacy and confidentiality in a professional manner.