Top 26 Clinical documentation specialist Jobs in Pittsburgh Pa

Medical Billing and Coding Specialist
Allies for Health and Wellbeing —Pittsburgh, PA
- $21 - $27 an hour
- Anatomy knowledge
- Current TB test
- Customer service
Quick Apply
Registered Nurse - Clinical Informatics Specialist
US Department of Veterans Affairs —Pittsburgh, PA
- $71,798 - $147,862 a year
- Full-time
- Nursing
- RN License
- Bachelor of Science
- Paid parental leave
- Health savings account
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Professional Staff Nurse, OP- Shadyside
UPMC - Pittsburgh Medical Center —Pittsburgh, PA
- $28.48 - $43.85 an hour
- Full-time
- CPR Certification
- Nursing
- RN License
- Paid parental leave
- Dental insurance
8d
Professional Staff Nurse, OP- Flex Full-time, Shadyside
UPMC - Pittsburgh Medical Center —Pittsburgh, PA
- $28.48 - $43.85 an hour
- Full-time
- CPR Certification
- Nursing
- RN License
- Paid parental leave
- Dental insurance
8d
Research Health Science Specialist
US Veterans Health Administration —Pittsburgh, PA
- Temporary
- Background check
- Pass drug screening
- Mid-level
8d
Clinical Informatics Specialist (RN)
Penn Highlands Healthcare —Monongahela, PA
- Full-time
- Nursing
- 6 years
- RN License
- 403(b) matching
- Disability insurance
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Claims Processing Specialist - Tarentum, PA
Blackburn's Physicians Pharmacy, Inc. —Tarentum, PA
- Full-time
- Computer literacy
- Mid-level
- Office
- Profit sharing
- Paid holidays
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Registered Nurse (RN) – In home Urgent Care - Part Time - Pittsburgh PA
Wellbe Senior Medical —Pittsburgh, PA
- $37.25 - $54.12 an hour
- Part-time
- CPR Certification
- Google Workspace
- Clean driving record
Registered Nurse (RN) – In home Urgent Care - Pittsburgh PA
Wellbe Senior Medical —Pittsburgh, PA
- $77,482 - $112,575 a year
- Full-time
- CPR Certification
- Google Workspace
- Clean driving record
Triage Nurse
ALLERGY & CLINICAL IMMUNOLOGY ASSOCIATES —Bethel Park, PA
- From $25 an hour
- Full-time
- Background check
- Anatomy knowledge
- Blood sampling
Quick Apply
12d
Staff RN - ECMO Spec / FT, nights
Children's Nebraska —United States
- Overtime
- Nursing
- RN License
- BLS Certification
- Flexible schedule
Staff RN - ECMO Spec / FT, D/N
Children's Nebraska —United States
- Overtime
- Nursing
- RN License
- BLS Certification
- Flexible schedule
Travel IMC RN Job in Birmingham, Alabama
GIFTED Healthcare —United States
- $2,122.06 a week
- Overtime
- Nursing
- Medication administration
- RN License
- Health insurance
- Dental insurance
Quick Apply

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UPMC - Pittsburgh Medical Center —Pittsburgh, PA
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)…
$36.73 - $60.52 an hour
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RN Case Manager
Community LIFE —Wilkinsburg, PA
Active RN license in Pennsylvania. Conduct in-home assessments and develop individualized care plans. Community LIFE is a Program of All-Inclusive Care for the…
$72,000 - $85,000 a year
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Medical Billing and Coding Specialist

Allies for Health and Wellbeing -
Pittsburgh, PA

Quick Apply

Job Details

$21 - $27 an hour

Qualifications

Health insurance authorizations
Appeals
Anatomy knowledge
Medicare
Customer service
Regulatory compliance in claims processing
HIPAA
Patient management software
Patient service
High school diploma or GED
Medicare regulations
Electronic health record (EHR) management for billing and coding
Health information regulatory compliance
Medical insurance appeals management
Centers for Medicare & Medicaid Services (CMS) billing regulations
Medicaid regulations
Medicaid
Productivity software
Clinical confidentiality policies
Insurance claims appeal handling
Medical terminology

Full Job Description

Description:

Position Overview

The Medical Billing and Coding Specialist is responsible for ensuring accurate coding, billing, claim submission, payment posting, denial management, and reimbursement of healthcare services. This position serves as a key member of the revenue cycle team by ensuring compliance with payer regulations, maximizing reimbursement, and supporting financial sustainability while maintaining excellent customer service. This position will report to the Chief Financial Officer.

Mission

To improve health and well-being, Allies provides integrated medical care, supportive human services, and community-based education for individuals living with, or at risk of HIV, viral hepatitis, and sexually transmitted infections.

Vision

Allies envisions a healthier community whereby people access integrated medical care and supportive human services in a respectful setting, free of stigma and discrimination.

Key Responsibilities

Review clinical documentation for completeness and accuracy.
Review and assign appropriate ICD-10-CM, CPT, HCPCS Level II, and modifier codes.
Query providers when documentation requires clarification.
Stay current on coding guidelines and payer requirements.
Verify claim accuracy prior to submission.
Correct rejected claims promptly.
Monitor claim status through clearinghouses and payer portals.
Work denials by solving, tracking and recommending process improvements.
Correct coding or billing errors.
Prepare appeals with supporting documentation.
Track denial trends and recommend process improvements.
Post insurance payments accurately.
Post patient payments.
Reconcile electronic remittance advice (ERA) and explanation of benefits (EOB).
Identify payment variances and underpayments.
Escalate contract discrepancies.
Follow up on unpaid claims.
Resolve aged receivables.
Maintain assigned A/R work queues.
Document payer communications.
Answer billing questions.
Explain insurance benefits and patient responsibility.
Assist patients with payment arrangements.
Coordinate with front office regarding registration and insurance issues.
Maintain HIPAA compliance.
Follow payer billing guidelines.
Participate in internal audits.
Report on potential compliance concerns.
Collaborate with clinical teams to improve documentation.
Participate in revenue cycle meetings

Organizational Expectations

Seek out up-to-date information about Allies’ programs and services, as well as relevant local, regional, and national health statistics that will inform and support our Mission
Improve job knowledge by remaining aware of new regulations and best practices; participating in educational opportunities; reading professional publications; maintaining personal networks; participating in professional organizations
Embrace and exemplify organizational standards and guiding principles for processes, protocols, and utilization
Commit to Allies’ promise to sustain and extend diversity, equity, and inclusion
Contribute to efforts which build and reinforce Allies’ distinctive, effective, and ethical practices

Requirements:

Knowledge Skills and Abilities

The Medical Billing and Coding Specialist should have demonstrated experience in the following areas: ICD-10-CM, CPT, HCPCS Level II, medical terminology, anatomy and physiology, insurance regulations, Medicare and Medicaid billing, commercial insurance billing, coordination of benefits, prior authorizations, appeals processes, HIPAA regulations.
Additional required skills: excellent attention to detail, time management, strong analytical skills, problem-solving, customer service, written and verbal communication, Microsoft Office proficiency, EHR and billing software proficiency.

Preferred Qualifications

Certification such as American Academy of Professional Coders: Certified Professional Coder (CPC), American Health Information Management Association: Certified Coding Specialist (CCS) or Certified Coding Associate (CCA) preferred.
Athena EMR experience preferred.

A high school diploma is required, associate’s degree in health information management, Medical Billing, or a related field preferred. 2-3 years of medical billing and coding experience preferred.

The Medical Billing and Coding Specialist will be called upon to engage in physical activity appropriate to Clinic and Office environments including the capacity to stand or sit for extended periods. Current PA child abuse, PA criminal history, Federal criminal history clearances, and verification of TB test performed within the last year are required within the first 30 days of employment.

Salary for this position begins at $21/hr-$27/hr commensurate with relevant education, experience, and licensure. We comply with EEOC.

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Refine Your Search

clinical documentation specialist jobs in pittsburgh pa

Medical Billing and Coding Specialist

Registered Nurse - Clinical Informatics Specialist

Professional Staff Nurse, OP- Shadyside

Professional Staff Nurse, OP- Flex Full-time, Shadyside

Research Health Science Specialist

Clinical Informatics Specialist (RN)

Claims Processing Specialist - Tarentum, PA

Registered Nurse (RN) – In home Urgent Care - Part Time - Pittsburgh PA

Registered Nurse (RN) – In home Urgent Care - Pittsburgh PA

Triage Nurse

Staff RN - ECMO Spec / FT, nights

Staff RN - ECMO Spec / FT, D/N

Travel IMC RN Job in Birmingham, Alabama

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