- St. Luke's University Health Network (Allentown, PA)
- …assigned MS- DRG or APR- DRG for the purpose of appealing proposed DRG and coding changes by insurance providers or their respective auditors JOB DUTIES ... and other governmental or commercial payor auditors in retrospective reviews for DRG and documentation or coding -related issues. Develop and apply appeal… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …mentorship, development, leadership programs and more! **Description** We are seeking an experienced ** Inpatient DRG Coding Auditor ** to extract data ... the accuracy of DRGs. This individual will: + Reviews inpatient medical records for select payer populations post-discharge and...an acute care setting. + Previous experience in performing DRG coding audits. + Possesses knowledge of… more
- Elevance Health (Grand Prairie, TX)
- ** DRG CODING AUDITOR ** **_Virtual_**...medical-expense spending. The ** DRG CODING AUDITOR ** is responsible for auditing inpatient medical ... DRG assignment accuracy. Specializes in review of DRG coding via medical record and attending...Registered Health Information Technician and/or CCS as a Certified Coding Specialist and/or CIC as a Certified Inpatient… more
- Humana (Montgomery, AL)
- …consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG) **So,** **do you** **love** **work** ... educational materials. This is a full-time, remote/work-from-home position. **Description** The Inpatient Medical Coding Auditor extracts clinical… more
- UCLA Health (Los Angeles, CA)
- Description As an Inpatient Coding Auditor with a specialization in DRG payment reviews, you will conduct thorough audits of inpatient coding to ... Conducting quality and DRG payment reviews for inpatient services to ensure accurate coding and...charge capture issues + Providing feedback and training to inpatient coding staff on best practices +… more
- AdventHealth (Tampa, FL)
- …Stroke Association as a Primary Stroke Center. **The ro** **le you'll contribute:** The Inpatient Coding Quality Auditor , under general supervision of the ... is responsible for the daily auditing of records. The Inpatient Coding Quality Auditor works...you'll bring to the team:** . Reviews records for DRG and overall coding accuracy retrospectively and… more
- Humana (Madison, WI)
- …of variable factors. **Responsibilities** The Senior Inpatient Medical Coding Professional confirms appropriate diagnosis related group ( DRG ) assignments. ... caring community and help us put health first** The Senior Inpatient Medical Coding Professional extracts clinical information from a variety of medical records… more
- AdventHealth (Maitland, FL)
- … Quality Manager, the Data Quality Reviewer is responsible for validating the coding performed by inpatient or outpatient coders. Random and/or target samples ... + Performs quality reviews on coded records to validate ICD-10, ICD-10-PCS, MS- DRG , APR-DRGs, and overall coding accuracy retrospectively and concurrently. +… more
- AdventHealth (Altamonte Springs, FL)
- …Monday-Friday **The role you will contribute:** The inpatient or outpatient coding team Quality Auditor (QA)/Educator supports the operations of the ... experience. Five years of inpatient or outpatient coding experience or Coding Quality Auditor...+ Expert level knowledge of Medicare Severity Diagnosis-Related Groups (MS- DRG ), and All Patient Refined Diagnosis-Related Groups (APR … more
- Sharp HealthCare (San Diego, CA)
- …the position, and employer business practices. **What You Will Do** The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's ... Qualifications** + Other : Strong background in in ICD-10-CM/PCS coding , DRG coding and CPT... ComplianceCompliance Coding and Billing AuditsThe Compliance Coding Auditor has the primary responsibility of… more
- Houston Methodist (Houston, TX)
- …must live in TX, LA, FL, TN, WA or GA** At Houston Methodist, the Coding Quality Auditor position is responsible for ensuring accuracy in code assignment of ... **SERVICE ESSENTIAL FUNCTIONS** + Responds promptly to internal and external customer coding / DRG requests. Responds promptly to Business Office requests to code… more
- Highmark Health (Harrisburg, PA)
- …HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding , DRG /APC structure according to regulatory requirements. Reports findings both ... or works with external resources to create and monitor inpatient case mix reports and the top 25 assigned...In-depth knowledge of ICD CM, ICD PCS and CPT/HCPCS coding systems. Must be proficient in DRG /APC… more
- ManpowerGroup (St. Paul, MN)
- Our client, a leader in healthcare innovations, is seeking an Inpatient Auditor to join their team. As an Inpatient Auditor , you will be part of the ... improvement, which will align successfully within the organization. **Job Title:** Inpatient Auditor **Location:** Remote **Pay Range:** $58-62 per hour… more
- MedKoder (Mandeville, LA)
- … veteran, the company offers services including inpatient and outpatient facility coding , medical risk adjustment management, DRG coding management, ... 40 hour work week that offers a flexible schedule Description: Physician Coding Auditor is responsible for reviewing and accurately coding all professional… more
- R1 RCM (Chicago, IL)
- …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our Inpatient Production Auditor , you will be responsible for auditing ... validation process while evaluating claim reimbursement potential based on coding assignment. To thrive you must be detail-oriented and...**Every day in this role you will:** + Audit inpatient cases for DRG validation + Review… more
- UNC Health Care (Chapel Hill, NC)
- …Abilities Requirements:** * Strong knowledge of ICD-10-CM, ICD-10-PCS, and CPT coding , MS DRG , hierarchical condition categories (HCC), and CDI ... the unique communities we serve. Summary: This positon trains and audits Inpatient and Outpatient Clinical Documentation Specialists (CDS) across all HCS entities… more
- Centene Corporation (New York, NY)
- …Group ( DRG ) and Medical Record Audit Programs for Fidelis Care. The Clinical Coding Auditor & Trainer position is primarily remote with a small travel ... with all policies and standards **Highly Preferred Skills:** + Inpatient Coding Experience + At least 1...degree in Nursing or equivalent experience. 4+ years of DRG and/or Medical Record Audit experience. One year of… more
- Northwell Health (Garden City, NY)
- …6.Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions. 7.Communicates DRG changes and rationale to the coding and CDI staff. ... RN - BSN or MSN candidates with a HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist-Clinical. Validates Acute Inpatient coded… more
- Amergis (San Antonio, TX)
- Salary: $40 / Hour Inpatient Denials Auditor must have experience with the following: - RAC / RAM Denials - Claim Adjustment Denials - PSI / HAC Reviews - Stroke ... Accounts - Creating Appeal Letters - Focused DRG Reviews for missed CC or MCC Comfortable with... Reviews for missed CC or MCC Comfortable with Re- Coding accounts and providing feedback to original coders EPIC… more
- Elevance Health (Seattle, WA)
- …(CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC. + ... -5PM (local time) The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical...Experience with third party DRG Coding and/or Clinical Validation Audits or… more
