University of Pittsburgh Medical CenterCertified Coding Specialist I (Risk Adjustment University of Pittsburgh Medical CenterCertified Coding Specialist I (Risk AdjustmentPittsburgh, PAIf 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.
West Virginia University MedicineNewProfessional 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.
University of Pittsburgh Medical CenterCoder II, Profee (ENT Coding University of Pittsburgh Medical CenterCoder II, Profee (ENT CodingPARemoteGraduate 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.
Highmark IncLead Hierarchical Condition Category (HCC) Coding Specialist (Remote) Highmark IncLead Hierarchical Condition Category (HCC) Coding Specialist (Remote)PARemoteApplies 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.
Ensemble Health PartnersPhysician Coding Auditor Ensemble Health PartnersPhysician Coding AuditorPittsburgh, PA$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.
Accenture PlcEpic 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.
St. Barnabas Health System IncHome Health RN--Oasis & Coding Specialist St. Barnabas Health System IncHome Health RN--Oasis & Coding SpecialistGibsonia, PAOur 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.
PricewaterhouseCoopers LLPManaged Services - Revenue Cycle Coding - Senior Manager PricewaterhouseCoopers LLPManaged Services - Revenue Cycle Coding - Senior ManagerPittsburgh, PA$124,000–$280,000 / yearPwC does not intend to hire experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth within the following policy: https://pwc.to/H-1B-Lottery-Policy. As a Senior Manager, you will leverage your skills and influence to deliver quality results, motivate and coach teams to solve complex problems, and apply sound judgment to recognize when to take action or escalate issues.
Deloitte Touche Tohmatsu LtdSenior Consultant, Health Insurance - Risk Regulatory & Compliance Deloitte Touche Tohmatsu LtdSenior Consultant, Health Insurance - Risk Regulatory & CompliancePittsburgh, PA$118,700–$218,600 / yearThe 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.
Deloitte Touche Tohmatsu LtdHospital Billing Coordinator Deloitte Touche Tohmatsu LtdHospital Billing CoordinatorPittsburgh, PA$50,000–$60,000 / yearOur 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.
All Stat PortableBilling Specialist All Stat PortableBilling SpecialistYoungstown, OHWe deliver high-quality bedside diagnostics to patients in skilled nursing facilities, rehab centers, and private residences. If you're an experienced Accounts Receivable or medical billing professional who values accuracy, compliance, and meaningful impact, we'd love to meet you.
All-Stat PortableBilling Specialist All-Stat PortableBilling SpecialistYoungstown, OhioWe deliver high-quality bedside diagnostics to patients in skilled nursing facilities, rehab centers, and private residences. Why You’ll Love This Role Meaningful impact: Your work directly supports accurate billing, compliance, and timely reimbursement.
Highmark IncNurse Practitioner or Physician Assistant - Outpatient Domain - Medical Oncology/Hematology Highmark IncNurse Practitioner or Physician Assistant - Outpatient Domain - Medical Oncology/HematologyButler, 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. 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).
enkompas Technology SolutionsNetsmart RCM Consultant enkompas Technology SolutionsNetsmart 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.
enkompas Technology SolutionsNetsmart 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.
Highmark IncSupervisor Strategic Risk Adjustment and Quality Highmark IncSupervisor Strategic Risk Adjustment and QualityPAOversee 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.
ElwynRevenue Cycle Specialist ElwynRevenue Cycle SpecialistPAMinimum 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.
Highmark IncPhysician 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.
Highmark IncPhysician Assistant or Nurse Practitioner - Inpatient Domain Hospitalist Highmark IncPhysician Assistant or Nurse Practitioner - Inpatient Domain HospitalistCanonsburg, PANational Board Certification for Nurse Practitioners through the American Academy of Nurse Practitioners (AANP) or American Nurses Credentialing Center (ANCC) or National Certification Corporation (NCC) or Pediatric Nursing Certification Board (PNCB). Physician Assistant or Nurse Practitioner - Inpatient Domain Hospitalist Explore our jobs Physician Assistant or Nurse Practitioner - Inpatient Domain Hospitalist Apply Open in new tab icon.
Highmark IncPhysician Assistant or Nurse Practitioner - Inpatient - Hospitalist Highmark IncPhysician Assistant or Nurse Practitioner - Inpatient - HospitalistPittsburgh, PASkip 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.
Pearle VisionOphthalmic Technician Pearle VisionOphthalmic TechnicianPittsburgh, PennsylvaniaThe 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.
Mercy HealthRadiology Clerical Associate - Radiology Department - St. Elizabeth Youngstown Hospital Mercy HealthRadiology Clerical Associate - Radiology Department - St. Elizabeth Youngstown HospitalYoungstown, OHComputer Office skills (Microsoft Office, STAR and database applications, Computerized scheduling system) • Medical and Anatomy terminology (Preferred) • Knowledge of Radiology practices (Preferred) • Clinical, clerical/registration secretarial experience desired • Operates basic office equipment and machinery (Fax, PC, telephone, Xerox) • Ability to perform multiple tasks. Frequently advises others on difficult and sensitive issues Must maintain a high level of confidentiality due to strict confidentiality issues related to Radiology, which include Administrative management, personnel, patients, and physician-related issues.
Deloitte Touche Tohmatsu LtdHospital Billing Analyst Deloitte Touche Tohmatsu LtdHospital Billing AnalystPittsburgh, PA$70,000–$90,000 / yearOur 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 IncPhysician Assistant - Inpatient Domain-Casual, Hospitalist Highmark IncPhysician Assistant - Inpatient Domain-Casual, HospitalistMonroeville, PANational 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). 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 IncNewNurse Practitioner or Physician Assistant- Outpatient Domain - Digestive Health Highmark IncNurse Practitioner or Physician Assistant- Outpatient Domain - Digestive HealthPittsburgh, 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. 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 IncPhysician Assistant or Nurse Practitioner - Inpatient Domain - Endocrinology Highmark IncPhysician Assistant or Nurse Practitioner - Inpatient Domain - EndocrinologyJefferson Hills, PANational 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). 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 IncPhysician Assistant or Nurse Practitioner - Inpatient Domain - Hospitalist Highmark IncPhysician Assistant or Nurse Practitioner - Inpatient Domain - HospitalistMonroeville, PANational 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). 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.(30%).
Highmark IncPhysician Assistant or Nurse Practitioner - Outpatient Domain, Neurology, Neuromuscular Division Highmark IncPhysician Assistant or Nurse Practitioner - Outpatient Domain, Neurology, Neuromuscular DivisionPittsburgh, 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 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 IncPhysician Assistant or Nurse Practitioner- Inpatient Critical Care Highmark IncPhysician Assistant or Nurse Practitioner- Inpatient Critical CarePittsburgh, PASkip 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 IncPhysician Assistant - Outpatient Domain - Surgery Highmark IncPhysician Assistant - Outpatient Domain - SurgeryMcMurray, 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.
Highmark IncNurse Practitioner or Physician Assistant - Outpatient Domain Part-Time - Primary Care Highmark IncNurse Practitioner or Physician Assistant - Outpatient Domain Part-Time - Primary CareBethel Park, 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 offices and non-acute based settings. Nurse Practitioner or Physician Assistant - Outpatient Domain Part-Time - Primary Care Explore our jobs Nurse Practitioner or Physician Assistant - Outpatient Domain Part-Time - Primary Care Apply Open in new tab icon.
Highmark IncPhysician Assistant or Nurse Practitioner - Inpatient Domain-Casual, Hospitalist Highmark IncPhysician Assistant or Nurse Practitioner - Inpatient Domain-Casual, HospitalistMonroeville, PANational 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). 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 IncNurse Practitioner or Physician Assistant - Join our Open House Highmark IncNurse Practitioner or Physician Assistant - Join our Open HousePittsburgh, 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. 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 IncNurse Practitioner - Outpatient Domain - Women's Health Highmark IncNurse Practitioner - Outpatient Domain - Women's HealthPittsburgh, 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. 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 IncPhysician Assistant - Inpatient Domain (A) Neurosurgery Highmark IncPhysician Assistant - Inpatient Domain (A) NeurosurgeryPittsburgh, PAThis 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.(30%). Facilitates seamless communication and coordination of patient care activities with patients, families, community health services, and the entire interdisciplinary healthcare team to ensure continuity of care and optimal patient experience.
Heartflow IncField Reimbursement Manager - Mid-Atlantic Heartflow IncField Reimbursement Manager - Mid-AtlanticPittsburgh, PARemote$90,000–$120,000 / yearExceptional Communication: Outstanding presentation and communication skills, with the ability to translate complex reimbursement information into clear, actionable guidance for both internal teams and external customers. Cross-Functional Alignment: Proven ability to successfully collaborate and align with a direct sales force, serving as a respected consultative partner rather than a purely service-oriented resource.
Highmark IncProvider Contract Analyst Highmark IncProvider Contract AnalystWorking at Home, PAThe 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.
University of Pittsburgh Medical CenterPatient Services Representative - University OB/GYN - Magee Women's Hospital University of Pittsburgh Medical CenterPatient Services Representative - University OB/GYN - Magee Women's HospitalPittsburgh, PAPurpose: A Patient Services Representative is responsible for welcoming patients upon arrival, promoting the usage of new and emerging consumer-friendly technologies, educating patients on their copayments and financial obligations and collecting payments when applicable, scheduling subsequent appointments within the continuum of care, connecting patients to financial advocacy resources when appropriate, updating patient's demographics and insurance coverage information, and promoting an overall culture of service excellence. Patient Services Representative display strong customer service skills that ensure that patients and family members have the desired UPMC Experience at UPMC physician practices, hospitals, and outpatient surgery departments.
University of Pittsburgh Medical CenterPatient Services Representative - OB/GYN (Bethel Park, PA University of Pittsburgh Medical CenterPatient Services Representative - OB/GYN (Bethel Park, PABethel Park, PAPurpose: A Patient Services Representative is responsible for welcoming patients upon arrival, promoting the usage of new and emerging consumer-friendly technologies, educating patients on their copayments and financial obligations and collecting payments when applicable, scheduling subsequent appointments within the continuum of care, connecting patients to financial advocacy resources when appropriate, updating patient's demographics and insurance coverage information, and promoting an overall culture of service excellence. Patient Services Representative display strong customer service skills that ensure that patients and family members have the desired UPMC Experience at UPMC physician practices, hospitals, and outpatient surgery departments.
University of Pittsburgh Medical CenterLocation Supervisor- nights, Oakland University of Pittsburgh Medical CenterLocation Supervisor- nights, OaklandPittsburgh, PABachelor'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.
Recordati SpAField Reimbursement Manager (Cincinnati, OH or Pittsburg, PA) Recordati SpAField Reimbursement Manager (Cincinnati, OH or Pittsburg, PA)Pittsburgh, PARemote$144,000–$198,000 / yearRecordati 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 IncCoder - Outpatient Highmark IncCoder - OutpatientWorking at Home, PAIn 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.
University of Pittsburgh Medical CenterClinical Auditor/Analyst (Remote- Fraud, Waste and Abuse University of Pittsburgh Medical CenterClinical Auditor/Analyst (Remote- Fraud, Waste and AbusePittsburgh, PARemoteQuery 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 IncSenior Medical Underwriter Highmark IncSenior Medical UnderwriterPAIn 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.
Deloitte Touche Tohmatsu LtdHealthcare Revenue Cycle Senior Consultant Deloitte Touche Tohmatsu LtdHealthcare Revenue Cycle Senior ConsultantPittsburgh, PA$128,000–$252,500 / yearOur 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. 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.
Deloitte Touche Tohmatsu LtdHealthcare Revenue Cycle Consulting Manager Deloitte Touche Tohmatsu LtdHealthcare Revenue Cycle Consulting ManagerPittsburgh, PA$155,600–$306,800 / yearThe 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. 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.
Highmark IncCoordinator Billing Regional - Women's Institute - West Penn - Full Time (Hybrid) Highmark IncCoordinator Billing Regional - Women's Institute - West Penn - Full Time (Hybrid)Pittsburgh, PAIn 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 IncCoder - Inpatient (CCS/CIC REQUIRED), Remote, Sign on Bonus Eligible Highmark IncCoder - Inpatient (CCS/CIC REQUIRED), Remote, Sign on Bonus EligibleWorking at Home, PARemoteIn 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.
CVS Health CorpPharmacy Care Technician - Work From Home (Monroeville, PA) CVS Health CorpPharmacy Care Technician - Work From Home (Monroeville, PA)Monroeville, PA$17–$28.46 / hourPharmacy Care Technicians assist with inbound phone calls; interact with customers and cross functional team to answer questions, solve problems, provide education, and maintain our company's reputation for high-quality service. In this role, you will assist in accurately reading, interpreting and entering prescriptions into the computer system including calculation of doses and assignment of directions and accepting proper insurance payment in a timely fashion.
University of Pittsburgh Medical CenterDRG Specialist University of Pittsburgh Medical CenterDRG SpecialistPittsburgh, PALicensure, 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.