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

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    Chief Medical Officer, Family Hospice UPMC Southwestern PA

    Chief Medical Officer, Family Hospice
    Castle Shannon, PA

    UPMC Family Hospice partners closely with UPMC hospitals, service lines, and the UPMC Palliative and Supportive Institute (PSI) to deliver high?quality, patient?centered care across inpatient, outpatient, and community settings. The work environment involves high risks with exposure to potentially dangerous situations or unusual environmental stress, including exposure to blood or body fluids which requires the use of Personal Protective Equipment (PPEs), such as safety eyeglasses, face shield, surgical mask, gloves and/or gowns.

    Today

    Ambulance Medical Billing and Coding Associate DocGo Inc

    Ambulance Medical Billing and Coding Associate
    PA
    Remote
    • $21–$25 / hour

    DocGo's proprietary, AI-powered technology, logistics network, and dedicated field staff of over 5,000 certified health professionals elevate the quality of patient care and drive efficiencies for municipalities, hospital networks, and health insurance providers. About Ambulnz by DocGo: Ambulnz by DocGo is leading the proactive healthcare revolution with an innovative care delivery platform that includes mobile health services, population health, remote patient monitoring, and ambulance services.

    30+ days ago

    Professional Coding Specialist III - Cardiothoracic Surgery West Virginia University Medicine

    Professional Coding Specialist III - Cardiothoracic Surgery
    PA

    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.

    30+ days ago
    Highmark Inc logo

    Hierarchical Condition Category (HCC) Coding Specialist Highmark Inc

    Hierarchical Condition Category (HCC) Coding Specialist
    PA

    This 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.

    30+ days ago

    Coder II - Technical (Inpatient Coding University of Pittsburgh Medical Center

    Coder II - Technical (Inpatient Coding
    Pittsburgh, PA
    Remote

    Maintain 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.

    18 days ago

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

    Epic Resolute Application Developer (Charge Router and Coding Skills) - 6260321
    Pittsburgh, PA

    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.

    30+ days ago

    Physician Coding Auditor Ensemble Health Partners

    Physician Coding Auditor
    Pittsburgh, PA
    Remote
    • $57,400–$99,000 / 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.

    30+ days ago

    Coder III - Technical (Interventional Radiology and Cardiovascular Coding University of Pittsburgh Medical Center

    Coder III - Technical (Interventional Radiology and Cardiovascular Coding
    Pittsburgh, PA

    Maintain 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.

    8 days ago
    PwC logo

    Managed Services - Revenue Cycle Coding - Senior Manager PwC

    Managed Services - Revenue Cycle Coding - Senior Manager
    Pittsburgh, PA
    • $124,000–$280,000 / year

    PwC 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.

    14 days ago

    Security Testing Specialist - Code Review/Java, .NET, Python Developer The PNC Financial Services Group Inc

    Security Testing Specialist - Code Review/Java, .NET, Python Developer
    Pittsburgh, PA
    • $91,000–$185,900 / year

    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. Access Control (AC), Application Security, Application Security Code Review, Application Security Testing, Building Architecture, Customer Solutions, Disaster Recovery Planning, Information Security, Network Security, Physical Security, Risk Assessments, Security Technologies, Static Application Security Testing (SAST).

    18 days ago

    Software Engineer Principal - Data and Automation (Sagemaker, AWS CDK, Infrastructure as Code (IaC), Python, Pyspark) The PNC Financial Services Group Inc

    Software Engineer Principal - Data and Automation (Sagemaker, AWS CDK, Infrastructure as Code (IaC), Python, Pyspark)
    Pittsburgh, PA

    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. 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.

    30+ days ago

    Software Engineer Principal - Data and Automation (Sagemaker, AWS CDK, Infrastructure as Code (IaC), Python, Pyspark) PNC Bank

    Software Engineer Principal - Data and Automation (Sagemaker, AWS CDK, Infrastructure as Code (IaC), Python, Pyspark)
    Pittsburgh, Pennsylvania

    Amazon 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.

    20 days ago

    Medical Billing Assistant - Entry Level Vitalsearchgroup

    Medical Billing Assistant - Entry Level
    Pittsburgh, Pennsylvania

    The 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.

    30+ days ago

    Field Reimbursement Manager - Mid-Atlantic HeartFlow

    Field Reimbursement Manager - Mid-Atlantic
    Pittsburgh, PA
    Remote
    • $90,000–$120,000 / year

    Heartflow is the first AI-driven non-invasive integrated heart care solution across the CCTA pathway that helps clinicians identify stenoses in the coronary arteries (RoadMapAnalysis), assess coronary blood flow (FFRCT Analysis), and characterize and quantify coronary atherosclerosis (Plaque Analysis). The flagship product-an AI-driven, non-invasive cardiac test supported by the ACC/AHA Chest Pain Guidelines called the Heartflow FFRCT Analysis-provides a color-coded, 3D model of a patient's coronary arteries indicating the impact blockages have on blood flow to the heart.

    29 days ago
    Highmark Inc logo

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

    Physician Assistant or Nurse Practitioner- Outpatient Domain - Medical Oncology/Hematology
    Monaca, PA

    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%). 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).

    8 days ago
    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
    Bethel Park, PA

    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. While exercising significant autonomy in your practice, you will have a designated physician available for direct support, consultation, and supervision, ensuring compliance with all state licensure regulations and providing expert guidance and resources for the management of complex clinical cases.

    24 days ago

    Netsmart RCM Consultant enkompas Technology Solutions

    Netsmart RCM Consultant
    Sewickley, PA
    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.

    30+ days ago

    Netsmart EHR RCM Consultant enkompas Technology Solutions

    Netsmart EHR RCM Consultant
    Sewickley, PA
    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.

    30+ days ago
    Highmark Inc logo

    Supervisor Strategic Risk Adjustment and Quality Highmark Inc

    Supervisor Strategic Risk Adjustment and Quality
    PA

    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.

    18 days ago
    New

    Director of Revenue Cycle Planned Parenthood of Western Pennsylvania

    Director of Revenue Cycle
    Pittsburgh, PA

    Ensure complete, accurate, and timely data is maintained in Epic and that internal operations supports clean claim submission; identify and resolve data or workflow gaps that impact billing performance. Collaborate with Health Center Managers and Medical Services leadership to optimize front-end revenue cycle processes including patient registration, insurance verification, eligibility checking, sliding fee scale application, and point-of-service collections.

    4 days ago
    Highmark Inc logo
    New

    Physician Assistant - Inpatient Domain - Labor and Delivery - Casual Highmark Inc

    Physician Assistant - Inpatient Domain - Labor and Delivery - Casual
    Jefferson Hills, PA

    Assist with in house attending physicians to manage a busy L&D unit including but not limited to: triage, admissions, cervical checks, assisting in cesarean sections, assisting in vaginal deliveries, postpartum/antepartum rounds, gynecological consults. 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%).

    1 day ago
    Highmark Inc logo

    Physician Assistant or Nurse Practitioner - Inpatient - Hospitalist Highmark Inc

    Physician Assistant or Nurse Practitioner - Inpatient - Hospitalist
    Pittsburgh, PA

    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.

    30+ days ago
    Highmark Inc logo

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

    Physician Assistant - Outpatient Domain - Cardiac/Oncology Program
    Pittsburgh, PA

    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.

    30+ days ago
    Highmark Inc logo
    New

    Nurse Practitioner or Physician Assistant - Outpatient Domain Part-Time - Outpatient Medical Oncology Highmark Inc

    Nurse Practitioner or Physician Assistant - Outpatient Domain Part-Time - Outpatient Medical Oncology
    Pittsburgh, PA

    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.(30%). 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.

    5 days ago

    Billing Specilaist Mon Vale HealthPlex Penn Highlands Healthcare

    Billing Specilaist Mon Vale HealthPlex
    PA

    Summary: AS A BILLING SPECIALIST I, you'll be responsible for billing and collecting patient accounts receivable balances from the insurance companies in a prompt and efficient manner. This position interprets all contracts and determines the correct and timely payment and ensures the work-flow of the billing department runs smoothly.

    30+ days ago

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

    Medical Receptionist-Scott Township
    Pittsburgh, PA
    • Full time

    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.

    30+ days ago

    Medical Receptionist- McMurray, PA Preferred Primary Care Physicians, Inc.

    Medical Receptionist- McMurray, PA
    Canonsburg, PA
    • Full time

    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. Closeout procedures, gathering encounter forms, processing daily activities of coding, batching, billing and hospital visits.

    30+ days ago

    Ophthalmic Technician Pearle Vision

    Ophthalmic Technician
    Pittsburgh, Pennsylvania

    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.

    30+ days ago
    Highmark Inc logo
    New

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

    Nurse Practitioner or Physician Assistant - Outpatient Domain - Medical Oncology
    Natrona Heights, PA

    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. Communicates with attending physician regarding plan of care and involves physician in clinical decision making of any issues that are outside the CRNP"s knowledge base or scope of practice.

    2 days ago
    Highmark Inc logo

    Nurse Practitioner or Physician Assistant - Outpatient Domain Part-Time - Primary Care Highmark Inc

    Nurse Practitioner or Physician Assistant - Outpatient Domain Part-Time - Primary Care
    Bethel Park, PA

    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. 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.

    30+ days ago
    Highmark Inc logo
    New

    Physician Assistant - Inpatient Domain - Palliative Care Highmark Inc

    Physician Assistant - Inpatient Domain - Palliative Care
    Pittsburgh, PA

    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. 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.

    2 days ago
    Highmark Inc logo
    New

    Physician Assistant or Nurse Practitioner - Outpatient Domain - Oncology Highmark Inc

    Physician Assistant or Nurse Practitioner - Outpatient Domain - Oncology
    Pittsburgh, PA

    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%). 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).

    5 days ago
    Highmark Inc logo

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

    Nurse Practitioner or Physician Assistant- Outpatient Domain - Digestive Health
    Pittsburgh, PA

    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.

    30+ days ago
    Highmark Inc logo

    Physician Assistant or Nurse Practitioner- Inpatient Critical Care Highmark Inc

    Physician Assistant or Nurse Practitioner- Inpatient Critical Care
    Pittsburgh, PA

    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.

    30+ days ago
    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, PA

    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).

    30+ days ago
    Highmark Inc logo

    Nurse Practitioner or Physician Assistant - Outpatient Domain (A) - Cardiology Highmark Inc

    Nurse Practitioner or Physician Assistant - Outpatient Domain (A) - Cardiology
    Pittsburgh, PA

    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 (30%). 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.

    11 days ago
    Highmark Inc logo

    Nurse Practitioner or Physician Assistant- Inpatient Domain (A) Critical Care Highmark Inc

    Nurse Practitioner or Physician Assistant- Inpatient Domain (A) Critical Care
    Jefferson Hills, PA

    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. 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.

    10 days ago
    Highmark Inc logo

    Nurse Practitioner - Outpatient Domain (B) - Women's Health Highmark Inc

    Nurse Practitioner - Outpatient Domain (B) - Women's Health
    Sewickley, PA

    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.

    29 days ago

    Healthcare Compliance Auditor, Senior I University of Pittsburgh Medical Center

    Healthcare Compliance Auditor, Senior I
    Pittsburgh, PA

    Leveraging expertise in healthcare operations, reimbursement methodologies, and regulatory requirements, this position conducts auditing and monitoring activities and collaborates with clinical, operational, revenue cycle, and compliance stakeholders to promote adherence to regulatory requirements. The Healthcare Compliance Auditor Senior I plays a key role in supporting UPMC's compliance and regulatory oversight activities through the identification, assessment, and mitigation of healthcare compliance risks.

    24 days ago
    Highmark Inc logo
    New

    Coder - Outpatient Highmark Inc

    Coder - Outpatient
    PA

    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.

    5 days ago
    New

    Epic Revenue Cycle Senior Consultant Deloitte Touche Tohmatsu Ltd

    Epic Revenue Cycle Senior Consultant
    Pittsburgh, PA
    • $116,200–$229,100 / year

    Partner with Patient Access, revenue cycle operations, Health Information Management (HIM)/coding, and Patient Financial Services (PFS) leadership to translate requirements into Epic design, manage decision logs and change control, and document build specifications and test scripts. 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.

    5 days ago

    Payment Accuracy Analyst, Senior - Hybrid University of Pittsburgh Medical Center

    Payment Accuracy Analyst, Senior - Hybrid
    Pittsburgh, PA

    Here's what your day-to-day will look like: Collaborate across teams: Partner with Claims Operations, Medical Policy, IT, and more to align edits with clinical and financial goals. Bachelor's degree and 4 years of relevant experience OR equivalent combination of education & work within healthcare payers/claims payment processing will be considered.

    22 days ago
    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
    PA
    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.

    30+ days ago
    UnitedHealth Group Inc. logo
    New

    Program Integrity Manager, Pennsylvania - Remote UnitedHealth Group Inc.

    Program Integrity Manager, Pennsylvania - Remote
    Pittsburgh, PA
    Remote
    • $91,700–$163,700 / year

    The Program Integrity Manager is an individual contributor role responsible for fraud, waste and abuse and specific research leading to best practice policy implementation and vendor/subcontractor monitoring to drive problem/process resolution for the New Mexico Medicaid health plan. Primary Responsibilities: Works to ensure that internal processes are executed, especially related to intersegment responsibilities, for fraud, waste, and abuse (FWA) vendors' instances of health care FWA by medical profession or insured member.

    4 days ago

    Hospice Nurse Practitioner, Full-Time Gentiva Health Services Inc (Inactive)

    Hospice Nurse Practitioner, Full-Time
    Pittsburgh, PA

    Complete all visit types for patients on services, including Medicare-required hospice Face-to-Face (F2F) visits within CMS established regulatory timeframes, History & Physical/Initial Comprehensive visits, Problem-focused Symptom Management visits, Admission visits, Goals of Care discussions, and routine follow up visits. The Nurse Practitioner will deliver advanced clinical care, perform patient management visits and hospice Face-to-Face (F2F) encounters for eligibility certification and recertification, and partner closely with physicians and interdisciplinary teams to ensure high-quality, compliant, and compassionate care.

    18 days ago

    ProFee Audit Specialist- PRN Datavant

    ProFee Audit Specialist- PRN
    United
    Remote
    • $35–$45 / hour

    As a Profee Auditing Specialist, you will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, interim coding management, and coding workflow operations reviews. The estimated base pay range per hour for this role is: $35—$45 USD To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc.

    30+ days ago

    Profee Audit Specialist - FT Datavant

    Profee Audit Specialist - FT
    United
    Remote
    • $35–$45 / hour

    As a Profee Auditing Specialist, you will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, interim coding management, and coding workflow operations reviews. The estimated base pay range per hour for this role is: $35—$45 USD To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc.

    30+ days ago
    Highmark Inc logo
    New

    Physician Assistant or Nurse Practitioner - Inpatient Domain (A) - Hospitalist Highmark Inc

    Physician Assistant or Nurse Practitioner - Inpatient Domain (A) - Hospitalist
    Jefferson Hills, PA

    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). 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%).

    3 days ago
    CVS Health Corp logo

    Pharmacy Care Technician - Work From Home (Monroeville, PA) CVS Health Corp

    Pharmacy Care Technician - Work From Home (Monroeville, PA)
    Monroeville, PA
    • $17–$28.46 / hour

    Pharmacy 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.

    30+ days ago
    Highmark Inc logo

    Advanced Practice Provider - Pittsburgh, PA Highmark Inc

    Advanced Practice Provider - Pittsburgh, PA
    Pittsburgh, PA

    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.

    30+ days ago
    123

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