code core clinical data using appropriate classifications systems; analyze medical records according to published guidelines and requirements of UPMC, American College of Surgeons (ACoS), Pennsylvania Department of Health, and the Joint Commission on Accreditation of Health Organizations (JCAHO).
Licensed in the State of Pennsylvania. Five years of acute care clinical experience, two years payer or care management experience. Understanding of clinical and care management process. Knowledge of medical necessity criteria (InterQual). Ability to apply InterQual criteria appropriately.
A global insurance company is searching for a person to fill their position for a Remote Actuarial Senior Analyst I. Core Responsibilities of this position include: Effectively communicates issues and proposes solutions to current/existing analyses Constructing analytical approaches by
Scranton, PA Full Time External Experienced Position Summary The Director of Regulatory Compliance is responsible for providing reasonable assurance and attestation to Senior Management that there are effective and efficient policies and procedures in place to ensure the company is complying with
Medical, dental and vision, including free preventive care. Equal Opportunity Employer. Job: Contact Center. Primary Location: United States-Pennsylvania-Philadelphia. Schedule: Full-time. Employee Status: Regular. Work From Home (100%): Yes.
Software Developer, Staff Job Title Software Developer, Staff Job Purpose What does a great Software Developer do? Are you ready to be a member of a dynamic, entrepreneurial software development team? You will be responsible for crafting custom add-ons for our core banking software (DNA
Senior Technical Recruiting Partner PA Description About the O'Connor Group Company provides complete, customized solutions in Talent Acquisition and Human Resource Consulting to companies ranging from Fortune 500 companies to small businesses. By working as an extension of
Senior Engagement Manager - Claim Performance products Transforming the future of healthcare isn't something we take lightly. It takes teams of the best and the brightest, working together to make an impact. As one of the largest healthcare technology companies in the U.S., we are a catalyst