NewDirector of Billing and Coding The Primary Health NetworkDirector of Billing and CodingSharon, PAReviews and interprets operational data to assess need for procedural revisions and enhancements; participates in the design and implementation of specific systems to enhance revenue and operating efficiency. The mission of Primary Health Network is to enhance the health and well-being of the communities we serve by fostering trust and ensuring that every individual has access to high-quality, compassionate and exceptional healthcare.
Medical Coding Specialist (remote) Southwoods HealthMedical Coding Specialist (remote)Boardman, OhioRemoteResponsible for the proper assignment of all CPT/HCPCS and ICD-10-CM diagnosis codes to ensure compliant coding of documentation provided for physician’s offices, specialty offices, hospitalist rounding, in office procedures, other as assigned. In this role, you will be responsible for the proper assignment of all CPT/HCPCS and ICD-10-CM diagnosis codes to ensure compliant coding across all assigned patient encounters.
Manager Clinical Performance & Quality Coding (Nurse Practitioner or PA) Elevance Health IncManager Clinical Performance & Quality Coding (Nurse Practitioner or PA)seven fields, PADevelop and manage clinical quality reviews to ensure peer review and clinical quality chart audit process including targeting chart reviews, auditing percentages, score guidelines feedback mechanism and ensure compliance with remediation procedures. Requires a master's in Nursing (or PA equivalent) and at least 3 years of clinical experience in applying appropriate diagnosis in the Medicare HCC Mode; or any combination of education and experience, which would provide an equivalent background.
Manager Clinical Performance & Quality Coding (Nurse Practitioner Or PA) Elevance HealthManager Clinical Performance & Quality Coding (Nurse Practitioner Or PA)Seven Fields, PADevelop and manage clinical quality reviews to ensure peer review and clinical quality chart audit process including targeting chart reviews, auditing percentages, score guidelines feedback mechanism and ensure compliance with remediation procedures. Requires a master's in Nursing (or PA equivalent) and at least 3 years of clinical experience in applying appropriate diagnosis in the Medicare HCC Mode; or any combination of education and experience, which would provide an equivalent background.
NewSenior Hierarchical Condition Category (HCC) Coding Specialist Highmark IncSenior Hierarchical Condition Category (HCC) Coding SpecialistPAThis job will deliver value to the Health Plan and its beneficiaries enrolled in risk-adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA) through Hierarchical Condition Category (HCC) coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and support of Risk Adjustment Data Validation (RADV) audits. Completes analytics on providers and/or provider group coding trends and creates and delivers externally facing presentations to provider documentation and accuracy, acts as the point person for the provider office for any questions and additional trainings, as needed.20%.
Senior Software Engineer (Claude Code or Google Gemini) Highmark IncSenior Software Engineer (Claude Code or Google Gemini)PATo include: 5 years in at least one modern programming languages (Java, Python, JavaScript, ACE, IIB/ITX, Informatica preferred), and experience with at least two of the following: React, Angular v4+, NodeJS, NoSQL databases, HTML5, CSS, Google Cloud Platform or Amazon Web Services. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.
NewBilling Supervisor The Primary Health NetworkBilling SupervisorSharon, PAEssential Function: Ensures the activities of the billing operations within the Network are conducted in a manner that is consistent with overall department protocol, and are in compliance with federal, state, and payer regulations, guidelines and requirements. The mission of Primary Health Network is to enhance the health and well-being of the communities we serve by fostering trust and ensuring inclusive and equitable access to healthcare that is both compassionate and exceptional.
Senior Field Reimbursement Specialist- Cell and Gene Therapy/Rare Disease Cencora IncSenior Field Reimbursement Specialist- Cell and Gene Therapy/Rare DiseasePA$93,500–$187,000 / yearProgressively responsible experience in field reimbursement, patient access, market access, revenue cycle, managed care, provider support, pharmaceutical/biologic support programs, or a related healthcare access role, with demonstrated experience working directly with health systems, hospitals, academic medical centers, authorized treatment centers, and/or large institutional accounts. This role will act as a liaison to patient assistance, reimbursement support, and access services offered by the client, with a focus on helping institutional stakeholders understand product acquisition pathways, CGT-specific prior authorization requirements, site-of-care considerations, coding and billing requirements, denial and appeal processes, and operational logistics that may affect timely access for patients with rare diseases.
Physician Assistant or Nurse Practitioner- Outpatient Domain - Medical Oncology/Hematology Highmark IncPhysician Assistant or Nurse Practitioner- Outpatient Domain - Medical Oncology/HematologyMonaca, 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%). 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).
Medical Billing Specialist Southwoods HealthMedical Billing SpecialistBoardman, OhioThe successful candidate will be responsible for submitting claims to third-party payers, resolving daily edits within our EMR and clearinghouse systems, and managing professional correspondence regarding billing inquiries. Collaboration: Follow up with Coding and Collection Specialists to accurately correct claims; report billing errors or needed policy changes to the supervisor.
Medical Billing Specialist ONE Health OhioMedical Billing SpecialistYoungstown, OHPerforms various collection actions including contacting patients by phone, correcting, and resubmitting claims to third-party payers. Finger dexterity required to manipulate objects with fingers rather than with whole hand(s) or arm(s), for example, using a keyboard.
Medical Billing Specialist One Health OhioMedical Billing SpecialistYoungstown, OHPerforms various collection actions including contacting patients by phone, correcting, and resubmitting claims to third-party payers. Finger dexterity required to manipulate objects with fingers rather than with whole hand(s) or arm(s), for example, using a keyboard.
Nurse Practitioner - Outpatient Domain - Pain Managment Highmark IncNurse Practitioner - Outpatient Domain - Pain ManagmentWexford, 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.
Medical Billing Specialist – Home Health Southwoods HealthMedical Billing Specialist – Home HealthBoardman, OhioThe successful candidate will be responsible for submitting claims to third-party payers, resolving edits daily within the EMR and clearinghouse, and handling correspondence regarding billing inquiries. Determine the need for supporting documentation required by specific insurance companies or cases, and copy documents for inclusion with claims.
Physician Assistant or Nurse Practitioner - Inpatient Domain (A) Part-Time - Hospitalist Highmark IncPhysician Assistant or Nurse Practitioner - Inpatient Domain (A) Part-Time - HospitalistPANational 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.
Per Diem- Nurse practitioner - Butler Beaver Lawrence Counties UnitedHealth Group IncPer Diem- Nurse practitioner - Butler Beaver Lawrence CountiesEllwood City, PAClinical › 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.
Patient Access Representative Heritage Valley Health SystemPatient Access RepresentativeBeaver, PAThey are also responsible for combining ancillary schedules for all patients and for assisting patients with the automated check-in process via our patient kiosks. Preferred: Healthcare background and/or bachelor or associates degree, knowledge of ICD-9 or ICD-10 coding, medical terminology, billing, and health insurance rules/processes.
Coder - Outpatient Highmark IncCoder - OutpatientPAIn 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.
Coder - Inpatient (CCS/CIC REQUIRED), Remote, Sign on Bonus Eligible Highmark IncCoder - Inpatient (CCS/CIC REQUIRED), Remote, Sign on Bonus EligiblePARemoteIn 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.
Medical Records / HIM Scanning Specialist Southwoods HealthMedical Records / HIM Scanning SpecialistBoardman, OhioYou will assist in the compilation, scanning, and indexing of patient information into the Electronic Medical Record (EMR) while ensuring the accuracy and confidentiality of all facility files. Key Responsibilities: Document Management: Collect, scan, index, and file medical records into the EMR system accurately and promptly.