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JobsJobs in PennsylvaniaJobs in Butler, PAHealthcare Jobs in Butler, PAMedical Billing and Coding JobsCoding Jobs in Butler, PA
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Coding Jobs in Butler, PA

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    Jobs

    Highmark Inc logo

    Supervisor Coding Highmark Inc

    Supervisor Coding
    PA30+ days ago

    For accommodation requests please contact HR Services Online at HRServiceshighmarkhealth.orgCalifornia Consumer Privacy Act Employees Contractors and Applicants Notice Apply Job DetailsJob categoryMedical RecordsPosition TypeFull TimePosted2025-11-20T162301.1048590000LocationsPA Working at Home - PennsylvaniaLine of BusinessEntityRecruiterHiring ManagerExperience LevelReq IDJ272888 Share Facebook X LinkedIn Whatsapp Email Copy URL Apply Open in new tab iconArrow left iconTwitter iconFacebook iconLinkedin iconInstagram iconYoutube iconGlassdoor icon Featured Links Competitively Sensitive Information Cyber Security Notice at Collection E-Verify English E-Verify - Employee Rights and Responsibilities Data Protection Sitemap Terms of Service Do Not SellShare E-Verify Spanish Digital Privacy Policy Highmark Health is an independent licensee of the Blue Cross Blue Shield Association. Apply for Supervisor Coding | Careers at Highmark Health Skip to main content Careers Working here Our Companies Career Areas Early CareersInterns Talent Community Team Member Stories Veterans Explore Jobs Medical RecordsSupervisor Coding Explore our jobs Supervisor Coding Apply Open in new tab iconPA Working at Home - PennsylvaniaCompany Allegheny Health NetworkJob Description GENERAL OVERVIEWPrimarily responsible for assisting the Coding Manager within the Coding Department.

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    Professional Coding Specialist III - Cardiothoracic Surgery West Virginia University Medicine

    Professional Coding Specialist III - Cardiothoracic Surgery
    PA3 days ago

    Accurately 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.

    Highmark Inc logo

    Lead Hierarchical Condition Category (HCC) Coding Specialist (Remote) Highmark Inc

    Lead Hierarchical Condition Category (HCC) Coding Specialist (Remote)
    PA25 days ago
    Remote

    Applies extensive clinical and coding knowledge and abilities, independently conducts coding research, aligns all aspects of audit, including coding adjudication and rebuttals with audit vendor, obtains provider attestations, identifies & obtains missing medical records, compares audit results to claims, and thoroughly reviews all in-house charts in chart repository for validation of audit. Completes analytics on providers and/or provider group coding trends and creates and delivers externally facing presentations to provider documentation and accuracy, act as the point person for the provider office for any questions and additional trainings, as needed.

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    Certified Coding Specialist I (Risk Adjustment University of Pittsburgh Medical Center

    Certified Coding Specialist I (Risk Adjustment
    Pittsburgh, PA11 days ago

    If you enjoy digging into medical records, applying your coding expertise, and making a meaningful impact on data accuracy and patient care-you'll feel right at home here. On a typical day, you'll: Review inpatient, outpatient, physician, and emergency department records to assign accurate diagnosis and procedure codes.

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    Coder II, Profee (ENT Coding University of Pittsburgh Medical Center

    Coder II, Profee (ENT Coding
    PA30+ days ago
    Remote

    Graduate of an approved certified coding program preferred with a curriculum that includes Anatomy and Physiology, Pharmacology, Pathophysiology, Medical Terminology, ICD-9-CM and CPT Coding Guidelines and Procedures. Identify incomplete documentation in the medical record and formulate a physician query to obtain missing documentation and/or clarification to accurately complete the coding process.

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    Physician Coding Auditor Ensemble Health Partners

    Physician Coding Auditor
    Pittsburgh, PA30+ days ago
    • $57,400–$99,000 Per Year

    The 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.

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    Epic Resolute Application Developer (Charge Router and Coding Skills) - 6260321 Accenture Plc

    Epic Resolute Application Developer (Charge Router and Coding Skills) - 6260321
    Pittsburgh, PA30+ days ago

    In 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.

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    Home Health RN--Oasis & Coding Specialist St. Barnabas Health System Inc

    Home Health RN--Oasis & Coding Specialist
    Gibsonia, PA30+ days ago

    Our mission is to ensure that retirees live comfortably, regardless of their ability to pay, by offering luxurious accommodations and a full continuum of care in a community-focused environment. St. Barnabas Health System is one of Pennsylvania's largest healthcare systems, dedicated to providing compassionate and comprehensive care since 1900.

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    Senior Consultant, Health Insurance - Risk Regulatory & Compliance Deloitte Touche Tohmatsu Ltd

    Senior Consultant, Health Insurance - Risk Regulatory & Compliance
    Pittsburgh, PA20 days ago
    • $118,700–$218,600 Per Year

    The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. Experience applying International Classification of Diseases, Tenth Revision (ICD-10), Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS) in claims, medical record, or appeals reviews.

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    Hospital Billing Coordinator Deloitte Touche Tohmatsu Ltd

    Hospital Billing Coordinator
    Pittsburgh, PA19 days ago
    • $50,000–$60,000 Per Year

    Our purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities. This compensation range is specific to the remote role and takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs.

    Highmark Inc logo

    Nurse Practitioner or Physician Assistant - Outpatient Domain - Medical Oncology/Hematology Highmark Inc

    Nurse Practitioner or Physician Assistant - Outpatient Domain - Medical Oncology/Hematology
    Butler, PA30+ days ago

    Provides 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. National Board Certification for Nurse Practitioners through the American Academy of Nurse Practitioners (AANP), American Nurses Credentialing Center (ANCC), National Certification Corporation (NCC), or Pediatric Nursing Certification Board (PNCB).

    Highmark Inc logo

    Supervisor Strategic Risk Adjustment and Quality Highmark Inc

    Supervisor Strategic Risk Adjustment and Quality
    PA30+ days ago

    Oversee the teams' processes to conduct multiple type of audits, government and internal, identify gaps, repeating issues and communicate results in provider office sites with data analysis from office site and/or medical record reviews to (a) continually improve the care, service to members and patient satisfaction; (b) coordination with other Highmark programs for credentialing, quality improvement programs, value based programs, care management programs, to achieve high caliber results, and (c) ensure medical records meet regulatory requirements. Contribute to the department's strategic planning efforts by identifying tactical opportunities for improvement, recommending solutions, and developing materials especially directed at Risk Adjustment, Quality/HEDIS, and Medical Record Documentation projects related to the development and implementation of educational opportunities.

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    Netsmart RCM Consultant enkompas Technology Solutions

    Netsmart RCM Consultant
    Sewickley, PA6 days ago
    Remote

    Revenue 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.

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    Netsmart EHR RCM Consultant enkompas Technology Solutions

    Netsmart EHR RCM Consultant
    Sewickley, PA28 days ago
    Remote

    Revenue 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.

    Highmark Inc logo

    Physician Assistant or Nurse Practitioner - Inpatient - Hospitalist Highmark Inc

    Physician Assistant or Nurse Practitioner - Inpatient - Hospitalist
    Pittsburgh, PA30+ days ago

    Skip to main content Careers Working here Our Companies Career Areas Early Careers Interns Talent Community Team Member Stories Veterans Explore Jobs Direct Patient Care Providers. This includes conducting thorough daily rounds, performing advanced medical history and physical assessments, formulating and implementing patient-centered treatment plans, interpreting diagnostic test results, and facilitating safe and effective discharge planning.

    Highmark Inc logo

    Physician Assistant - Outpatient Domain - Cardiac/Oncology Program Highmark Inc

    Physician Assistant - Outpatient Domain - Cardiac/Oncology Program
    Pittsburgh, PA30+ days ago

    Provides 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.

    Elwyn logo

    Revenue Cycle Specialist Elwyn

    Revenue Cycle Specialist
    PA30+ days ago

    Minimum of three (3) years of demonstrable progressive experience in medical billing • Demonstrated ability to enter and process minimum 200 claims per day depending upon billing system • Must be familiar with external payer portals and clearinghouses; Navinet, Promise preferred • Demonstrated understanding of policy deductibles, co pays, and coinsurance and out of pocket maximums • Demonstrated understanding of billing revenue codes CPT/HCPCS and claim forms UB/HCFA • Demonstrated knowledge of ICD-10 diagnosis codes • Demonstrated knowledge of Explanation of Benefits (EOB) interpretation and balance billing requirements • Demonstrated extensive knowledge of medical terminology • Demonstrated ability to work effectively as part of a team • Demonstrated strong attention to detail • Demonstrated strong time management and organizational skills • Demonstrated excellent judgment with the ability to independently solve problems and make decisions with little or no need for direct supervision • Comfortable using computer with multiple screens • Must be familiar with patient eligibility portal, PA COMPASS preferred • Strong analytical skills • Ability to resolve billing issues as they occur and create lasting solutions to problems to prevent issues from occurring in the future • Ability to work in a fast-paced environment and manage and prioritize multiple, often competing, priorities • Must possess excellent customer interaction, collaboration, presentation, and written and verbal communication skills • Demonstrated intermediate experience with Microsoft Office applications, including Word, Excel, and Outlook; Crystal Report writer experience preferred • Experience using/knowledge of Electronic Health Record (EHR) / Electronic Medical Record (EMR). • Manage claims in an web-based billing and claiming environment with tasks including but not limited to accurately perform charge entry into clearinghouses and payer portals, confirming patient eligibility and plan coverage • Research and identify CPT/HCPCS billing revenue codes and utilize electronic claim forms UB/Healthcare Financing Administration (HCFA) to bill claims • Confirm appropriate ICD-10 diagnostic codes to ensure proper billing • Review Explanation of Benefits (EOBs) and confirm plan requirements to ensure all collectable revenue is identified • Communicate with peers and supervisors to address billing and claims issues as appropriate and as needed • Participates in internal billing audits to reduce billing errors and maximize collections • Be available for alternative work schedules including flexibility to work within the following time slots: 8:00am - 8:00pm; occasional evening and weekend work as needed based on workload • Generate daily batching reports based on total claims billed • Perform other duties as assigned.

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    Ophthalmic Technician Pearle Vision

    Ophthalmic Technician
    Pittsburgh, Pennsylvania30+ days ago

    The position will interact with patients/customers by delivering an exceptional patient/customer experience, foster patient/customer retention, and promotes outstanding associate/doctor satisfaction. Ability to provide enthusiastic and concise communication to meet/exceed customer expectations as well as foster positive and results-oriented associate, doctor and host relationships.

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    Hospital Billing Analyst Deloitte Touche Tohmatsu Ltd

    Hospital Billing Analyst
    Pittsburgh, PA25 days ago
    • $70,000–$90,000 Per Year

    Our purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities. This compensation range is specific to the remote role and takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs.

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    Medical Receptionist-Scott Township Preferred Primary Care Physicians, Inc.

    Medical Receptionist-Scott Township
    Pittsburgh, PA25 days ago

    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. Preferred Primary Care Physicians is currently recruiting for a full-time Medical Receptionist for a practice located in the Scott Township area.

    Highmark Inc logo

    Advance Practice Provider, Primary Care - Grove City Highmark Inc

    Advance Practice Provider, Primary Care - Grove City
    Grove City, PA30+ days ago

    For accommodation requests please contact HR Services Online at HRServiceshighmarkhealth.orgCalifornia Consumer Privacy Act Employees Contractors and Applicants Notice Apply Job DetailsJob categoryDirect Patient Care ProvidersPosition TypeFull TimePosted2025-11-25T162603.0837200000LocationsGrove City PA 16127 647 N Broad Street ExtLine of BusinessEntityRecruiterHiring ManagerExperience LevelReq IDJ273042 Share Facebook X LinkedIn Whatsapp Email Copy URL Apply Open in new tab iconArrow left iconTwitter iconFacebook iconLinkedin iconInstagram iconYoutube iconGlassdoor icon Featured Links Competitively Sensitive Information Cyber Security Notice at Collection E-Verify English E-Verify - Employee Rights and Responsibilities Data Protection Sitemap Terms of Service Do Not SellShare E-Verify Spanish Digital Privacy Policy Highmark Health is an independent licensee of the Blue Cross Blue Shield Association. 5QUALIFICATIONSMinimumGraduate from an ARC-PA accredited program ORGraduate from a Pennsylvania Board of Nursing Approved Masters or Post Masters programCurrent Pennsylvania Physician Assistant License OR Current Pennsylvania CRNP license and Current State of PA RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact eNLC.CRNPs must obtain Pennsylvania Prescriptive Authority license within 60 days of hireNational Board Certification for Nurse Practitioners through the American Academy of Nurse Practitioners AANP or American Nurses Credentialing Center ANCCrequired for CRNPsCPR - American Heart AssociationAct 34 Criminal Background Clearance CertificateAct 33 Child Abuse Clearance CertificateAct 73 FBI Fingerprinting Criminal Background Clearance CertificatePreferred1-3 years department specific experienceACLS certificationDEA licenseDisclaimer The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title.

    Highmark Inc logo

    Physician Assistant or Nurse Practitioner- Inpatient Critical Care Highmark Inc

    Physician Assistant or Nurse Practitioner- Inpatient Critical Care
    Pittsburgh, PA30+ days ago

    Skip to main content Careers Working here Our Companies Career Areas Early Careers Interns Talent Community Team Member Stories Veterans Explore Jobs Direct Patient Care Providers Physician Assistant or Nurse Practitioner- Inpatient Critical Care Explore our jobs Physician Assistant or Nurse Practitioner- Inpatient Critical Care Apply Open in new tab icon. This includes conducting thorough daily rounds, performing advanced medical history and physical assessments, formulating and implementing patient-centered treatment plans, interpreting diagnostic test results, and facilitating safe and effective discharge planning.

    Highmark Inc logo

    Nurse Practitioner - Outpatient Domain - Women's Health Highmark Inc

    Nurse Practitioner - Outpatient Domain - Women's Health
    Pittsburgh, PA11 days ago

    Provides 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. 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.

    Highmark Inc logo

    Nurse Practitioner or Physician Assistant - Join our Open House Highmark Inc

    Nurse Practitioner or Physician Assistant - Join our Open House
    Pittsburgh, PA11 days ago

    Provides 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. 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.

    Highmark Inc logo

    Physician Assistant or Nurse Practitioner - Outpatient Domain, Neurology, Neuromuscular Division Highmark Inc

    Physician Assistant or Nurse Practitioner - Outpatient Domain, Neurology, Neuromuscular Division
    Pittsburgh, PA30+ days ago

    Provides 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 offices and non-acute based settings. National Board Certification for Nurse Practitioners through the American Academy of Nurse Practitioners (AANP), American Nurses Credentialing Center (ANCC), National Certification Corporation (NCC), or Pediatric Nursing Certification Board (PNCB).

    Highmark Inc logo
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    Nurse Practitioner or Physician Assistant- Outpatient Domain - Digestive Health Highmark Inc

    Nurse Practitioner or Physician Assistant- Outpatient Domain - Digestive Health
    Pittsburgh, PA4 days ago

    Provides 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. 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.

    Highmark Inc logo

    Provider Contract Analyst Highmark Inc

    Provider Contract Analyst
    Working at Home, PA24 days ago

    The analyst will be heavily involved in provider-facing activities such as assisting with the Helion Provider Help Desk to answer questions related to Utilization Management and claims processing, collaborating with the development team to draft agreements, and assisting with health plan contract negotiations. 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.

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    Medical Records Clerk University Health Services Inc

    Medical Records Clerk
    CLARION, PA26 days ago

    Responsibilities The Medical Records Clerk manages, organizes, and maintains patient health records, ensuring accuracy, confidentiality, and accessibility for healthcare providers; Retrieve medical records for Providers, Patients, External sources and Staff; Ensure all records comply with HIPAA and other federal regulations, maintaining confidentiality and security of patient information. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom.

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    Location Supervisor- nights, Oakland University of Pittsburgh Medical Center

    Location Supervisor- nights, Oakland
    Pittsburgh, PA11 days ago

    Bachelor's Degree in business, healthcare administration, finance or related field and 1 year of healthcare billing, registration or patient business servicesOR High School Diploma or equivalent and 4 years of healthcare billing, registration or patient business servicesSupervisory experience preferred. They answer inbound calls into the UPMC tollfree line, Children's, Magee, Mercy, Presbyterian, Shadyside, and Passavant's McCandless and Cranberry, which, on average, is a 2.1 million call volume annually, to send pages and to connect to patients and offices.

    Highmark Inc logo

    Coder - Outpatient Highmark Inc

    Coder - Outpatient
    Working at Home, PA11 days ago

    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. 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.

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    Field Reimbursement Manager (Cincinnati, OH or Pittsburg, PA) Recordati SpA

    Field Reimbursement Manager (Cincinnati, OH or Pittsburg, PA)
    Pittsburgh, PA30+ days ago
    Remote
    • $144,000–$198,000 Per Year

    Recordati Rare Diseases, Inc. (RRD) develops high-impact therapies for rare diseases, focusing on providing treatments to underserved communities in the U.S. Our mission is to mitigate the impact of rare diseases through increased awareness, better diagnoses, and improved treatment access in endocrinology, metabolic, hematology and oncology franchises. Serve as subject matter experts on issues of coverage, access and reimbursement by providing compliant, limited support to US health care providers (HCPs) and their office staff in navigating the reimbursement landscape for products of Recordati Rare Diseases Inc. (RRD) after the HCP made an independent decision to prescribe.

    Highmark Inc logo

    Senior Medical Underwriter Highmark Inc

    Senior Medical Underwriter
    PA30+ days ago

    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. Gathers claims history data from multiple sources, interprets and provides clinical judgment on diagnosis and estimates to the requestors regarding the impact on future potential claims.

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    Clinical Auditor/Analyst (Remote- Fraud, Waste and Abuse University of Pittsburgh Medical Center

    Clinical Auditor/Analyst (Remote- Fraud, Waste and Abuse
    Pittsburgh, PA11 days ago
    Remote

    Query medical and/or pharmacy claims and conduct a risk assessment by performing data analysis and applying applicable coding guidelines, Health Plan policies and any applicable National Coverage Determination (NCD or Local Coverage Determination (LCD.Evaluate referrals from Pharmacy Benefit Manager (PBM by analyzing medical and pharmacy claims and associated clinical documentation in HealthPlaNET, Mars, Epic and/or Cerner. The Clinical Auditor/Analyst is an integral part of the Special Investigations Unit (SIU and is responsible for conducting clinical audits and reviews regarding the analysis of care and services related to clinical guidelines, coding requirements, regulatory requirements, and resource utilization.

    Highmark Inc logo

    Coordinator Billing Regional - Women's Institute - West Penn - Full Time (Hybrid) Highmark Inc

    Coordinator Billing Regional - Women's Institute - West Penn - Full Time (Hybrid)
    Pittsburgh, PA11 days ago

    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. Performs other duties as assigned or required, including but not limited to reviewing and verifying billing reports, registration, and chart audits.

    Highmark Inc logo

    Coder - Inpatient (CCS/CIC REQUIRED), Remote, Sign on Bonus Eligible Highmark Inc

    Coder - Inpatient (CCS/CIC REQUIRED), Remote, Sign on Bonus Eligible
    Working at Home, PA11 days ago
    Remote

    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. GENERAL OVERVIEW: This job performs thorough medical record review to abstract medical and demographic data, interpret and apply diagnoses and procedures utilizing ICD coding systems and assists in decreasing the average accounts receivable days.

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    DRG Specialist University of Pittsburgh Medical Center

    DRG Specialist
    Pittsburgh, PA30+ days ago

    Licensure, Certifications, and Clearances: Certified Coding Specialist (CCS OR Certified Professional Coder (CPC OR Certified Registered Nurse Practitioner OR Doctor of Medicine (MD OR Registered Health Information Administrator OR Registered Health Information Technician (RHIT OR Registered Nurse (RN) Act 34*Current licensure either in the state where the facility is located or, if the facility is in a state covered by the multistate Nursing Licensure Compact (NLC agreement, a multistate license issued by a participating NLC state. Preferred Experience: 3 years' experience in an inpatient coding role, or clinical acute care medical/surgical experience to include critical care in conjunction with expanded knowledge of coding and DRG assignment.

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    RN CLINICAL DOCUMENT CASE MANAGER - CDI SPECIALIST (CLINICAL DOCUMENTATION INTEGRITY) Independence Health System

    RN CLINICAL DOCUMENT CASE MANAGER - CDI SPECIALIST (CLINICAL DOCUMENTATION INTEGRITY)
    Butler, PA12 days ago
    Remote

    House work (mopping, scrubbing), health club exercising, treadmill work, stretching, yoga, walk/run-playwith children, aerobic class, dancing, carrying bucket/wood, auto body repair, shoveling snow, golf(carrying clubs). The incumbent assists to facilitate the required level of detail in clinical documentation by educating and communicating extensively with the Medical Staff, other members of the health care team and Medical Records coding staff and demonstrates improvement in metrics such as CMI, Core Measure compliance, volume of Medical Record coding queries, etc.

    Highmark Inc logo

    Advanced Practice Provider - Pittsburgh, PA Highmark Inc

    Advanced Practice Provider - Pittsburgh, PA
    Pittsburgh, PA30+ days ago

    The role proactively manages symptoms, guides advance care planning, and supports members with chronic or life-limiting illnesses to ensure optimal quality of life and health outcomes. 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.

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    Front Office Coordinator Healogics Inc

    Front Office Coordinator
    McKees Rocks, PA30+ days ago
    • $18.75–$23.05 Per Hour

    Learn more about this role here: Healogics is the largest provider of advanced wound care services in the United States, treating more than 300,000 chronic wound patients annually across over 600 sites. All Healogics employees must perform their job responsibilities according to all Healogics policies, Hospital policies, as well as to accrediting organizations, federal and state regulation, and to the Centers for Medicare and Medicaid Services (CMS) guidelines, as applicable.

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    New!

    Pre-Service Financial Counselor University of Pittsburgh Medical Center

    Pre-Service Financial Counselor
    Pittsburgh, PA4 days ago

    The Pre-Service Financial Counselor is responsible for creating accurate estimates utilizing the EPIC estimator, contacting patients to financially counsel them on their estimates, offering the appropriate pre-pay discounting, and collecting patient responsibilities for pre-scheduled hospital-based services. Must develop and manage positive working relationships with colleagues, management, 3rd party payers, patients or their representatives, physicians and hospital leadership.

    PricewaterhouseCoopers LLP logo

    Applied AI Health Data System Engineer-Senior Manager PricewaterhouseCoopers LLP

    Applied AI Health Data System Engineer-Senior Manager
    Pittsburgh, PA30+ days ago
    • $124,000–$280,000 Per Year

    Managing development teams in building healthcare AI and GenAI solutions, including analytical modeling, prompt engineering, Python-based development, testing, communication of results to clinical and operational stakeholders, front-end and back-end integration, and iterative use case development with health system clients; Documenting and analyzing healthcare business processes - across clinical operations, and population health programs - to identify AI and GenAI opportunities, gather requirements, define initial hypotheses, and develop solution approaches tailored to health system workflows; Collaborating with health system client teams - including clinical informatics, population health, and IT leaders - to understand their business and clinical problems and select the appropriate models, LLMs, and approaches for AI/GenAI use cases; Designing and solutioning AI/GenAI architectures for health system clients, including RAG-based clinical knowledge retrieval systems, agentic AI workflows for care management and revenue cycle automation, and custom LLM application builds with appropriate PHI safeguards; Managing teams to process healthcare unstructured and structured data - including clinical notes, discharge summaries, claims records, EHR data, and ADT feeds - for use as LLM context, including embedding of large clinical text corpora, generative SQL query development, and building connectors to EHR back-end databases; Managing daily operations of a global healthcare data science team on client engagements, reviewing developed models, providing feedback, and assisting in analysis of clinical and operational outcomes; Directing data engineers and other data scientists to deliver efficient, HIPAA-compliant solutions that meet health system client requirements for clinical, financial, and operational AI use cases; Leading and contributing to development of proof of concepts, pilots, and production use cases for health system clients - spanning clinical decision support, prior authorization automation, patient risk scoring, workforce optimization, and throughput modeling - while working in cross-functional teams; Facilitating and conducting executive-level presentations to health system leadership showcasing GenAI and ML solution capabilities, use case development progress, model performance, and recommended next steps; Structuring, writing, communicating, and facilitating client presentations that translate complex AI and ML concepts into clear clinical and business value narratives for health system audiences; and, Managing associates and senior associates through coaching, providing feedback, and guiding work performance, with an emphasis on developing healthcare domain knowledge alongside technical AI and ML capabilities. You will architect and build production-grade RAG pipelines, MCP connections, agentic AI workflows, and MLOps frameworks, managing daily operations across global delivery teams while engaging health system leaders at the executive level to ensure measurable clinical and operational impact.

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    Location Manager - Jefferson, PA Advanced Dermatology & Cosmetic Surgery

    Location Manager - Jefferson, PA
    Pittsburgh, PA18 days ago

    Benefits packages, including medical, dental, STD, LTD, Life, and other voluntary benefit offerings (for employees working 30+ hours per week). Advanced Dermatology and Cosmetic Surgery's mission is to deliver the highest quality patient care and experience in dermatology and aesthetic services.

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    Patient Access Representative Heritage Valley Health System

    Patient Access Representative
    Sewickley, PA30+ days ago

    They are also responsible for combining ancillary schedules for all patients and for assisting patients with the automated check-in process via our patient kiosks. They will collect and enter all necessary information to ensure accurate hospital records, including patients demographic and insurance information to facilitate the billing process.

    U

    Physician Educator HPL- Remote- Clearfield County, PA & Surrounding Area! University of Pittsburgh Medical Center

    Physician Educator HPL- Remote- Clearfield County, PA & Surrounding Area!
    Pittsburgh, PA30+ days ago
    Remote

    The Physician Educator is responsible for implementation of strategic plans and coordination of all aspects of provider and practice education, including but not limited to scheduling, tracking, follow-up, workflow integration, medical record documentation, coding, and electronic health records. Analyze medical record documentation and coding through a chart review process that identifies incorrect coding, coding lacking supporting documentation, and missed opportunities to capture risk adjustment diagnoses and associated revenue.

    M

    Senior Analyst - Provider Revenue Excellence McKinsey & Co Inc

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    Pittsburgh, PA30+ days ago

    Our engagements are typically focused on growth solutions that leverage cutting edge assets and expertise, revenue cycle management capabilities across the value chain to ensure maximum value capture, or pricing capabilities that enable providers to excel along the full managed care contracting life cycle. descriptive statistics, predictive analytics and machine learning • Strong analytical skills in claims, productivity, access, and volume data to identify trends and opportunities • Ability to work collaboratively in a team environment • Comfortable traveling to client sites, up to 60-70% of time traveling.

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    Mental Health Therapist (LPC, LCSW, LMFT) UnitedHealth Group Inc

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    Clinical › Corporate and business operations › Customer and support services › Early careers › Sales and account management › Technology and data › Physicians › Advanced practice clinicians › Pharmacy › Behavioral health › Nursing › Medical coding › Clinical support › U.S. › Ireland & UK › India › Philippines › Culture of Belonging › Employee Benefits › Blog. From clinical operations such as credentialing to business operations such as contracting we provide organizational support that allows our providers to focus on what matters - providing care.

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    Per Diem- Nurse practitioner - Butler Beaver Lawrence Counties UnitedHealth Group Inc

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    Clinical › Corporate and business operations › Customer and support services › Early careers › Sales and account management › Technology and data › Physicians › Advanced practice clinicians › Pharmacy › Behavioral health › Nursing › Medical coding › Clinical support › U.S. › Ireland & UK › India › Philippines › Culture of Belonging › Employee Benefits › Blog. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individuals physical mental and social needs - helping patients access and navigate care anytime and anywhere.

    U

    Coder I - Technical University of Pittsburgh Medical Center

    Coder I - Technical
    PA11 days ago
    Remote

    Determine diagnoses that were treated, monitored and evaluated and procedures done during the episode of care are sequenced in order of their clinical significance to accurately assign the appropriate APC/ASC or payment tier under the Prospective Payment system or DSM IV methodology to guarantee accurate reimbursement on UPMC patients. Completed an AHIMA or AACP-certified Coding program or certificate, Bidwell Training School or equivalent program with a curriculum that includes Anatomy and Physiology, Medical Terminology, ICD-9-CM/ICD 10 and CPT Coding Guidelines and Procedures.

    U

    Certified Professional Coder - Women's Health University of Pittsburgh Medical Center

    Certified Professional Coder - Women's Health
    Pittsburgh, PA20 days ago
    Remote

    Certified Coding Specialist (CCS OR Certified Coding Specialist - Physician-Based (CCS-P OR Certified Professional Coder (CPC OR Nationally Registered Certified Coding Specialist (NRCCS OR Registered Health Information Administrator OR Registered Health Information Technician (RHIT. Licensure, Certifications, and Clearances: Certified Coding Specialist (CCS OR Certified Professional Coder (CPC OR Registered Health Information Administrator OR Registered Health Information Technician (RHIT OR Certified Coding Specialist - Physician Based (CCS-P required.

    U

    Coder II, Profee University of Pittsburgh Medical Center

    Coder II, Profee
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    Remote

    Graduate of an approved certified coding program preferred with a curriculum that includes Anatomy and Physiology, Pharmacology, Pathophysiology, Medical Terminology, ICD-9-CM/ICD-10 and CPT Coding Guidelines and Procedures. Depending on the type of service and place of service, you will determine the level of acuity, procedure(s performed, billable supplies, and diagnosis to substantiate medical necessity.

    12

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