- Insight Global (South Jordan, UT)
- Job Description Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100% remote. The work authorization is not specified and the ... of understanding of reimbursement guidelines specifically an understanding of the MS- DRG , AP- DRG , and APR- DRG payment systems. This position is responsible… more
- Elevance Health (Roanoke, VA)
- ** DRG Coding Auditor Principal** **_Virtual: _** _ _ This role enables associates to work virtually full-time, with the exception of required in-person training ... is determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** DRG Coding Auditor Principal** is responsible for auditing inpatient… more
- Elevance Health (Norfolk, VA)
- ** DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ __ This role enables associates to work virtually full-time, with the exception of required in-person training ... is determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** DRG CODING AUDITOR ** is responsible for auditing inpatient medical… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …leadership programs and more! **Description** We are seeking an experienced **Inpatient DRG Coding Auditor ** to extract data from patient encounters ensuring ... the accuracy and completeness of diagnosis and procedure coding, DRG assignment, and abstracted data POA, Discharge Disposition. +...+ Reviews discrepancies between the Clinical Documentation Specialist (CDS) DRG and the Coder DRG . + Reviews… more
- University of Michigan (Ann Arbor, MI)
- DRG COMPLIANCE AUDITOR (DCA) **Early Site Maintenance** We are performing updates and maintenance to our applicant experience. As a result, the site will be ... employer. **Job Detail** **Job Opening ID** 271520 **Working Title** DRG COMPLIANCE AUDITOR (DCA) **Job Title** Medical Coder Compliance Spec **Work Location**… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The DRG Denials Auditor conducts hospital inpatient DRG denial audits for both RAC and non-RAC accounts, reviewing patient records for ... accuracy in ICD-10-CM/PCS coding, DRG assignments, and supporting clinical documentation. This includes evaluating...any other relevant data to ensure coding accuracy. The auditor is also responsible for writing and defending appeal… more
- HCA Healthcare (Nashville, TN)
- …with purpose and integrity. We care like family! Jump-start your career as a DRG Validation Auditor today with Parallon. **Benefits** Parallon offers a total ... Today! **Job Summary and Qualifications** As a work from home Inpatient Coding Auditor , you will be responsible for performing internal quality assessment reviews on… more
- Insight Global (Plano, TX)
- …more years working in an acute care setting or a third-party vendor as a DRG Auditor or Clinical Documentation Specialist (CDS). -CCS Certification RN or BSN ... DRG Auditors to join a remote healthcare organization. The DRG Revenue Integrity Auditor will perform Diagnostic Related Group ( DRG ) validation and… more
- University of Utah Health (Salt Lake City, UT)
- …position audits the accuracy and completeness of diagnosis and procedure coding, DRG assignment, and abstracted data to support that appropriate reimbursement and ... audits the accuracy and completeness of diagnoses, procedure coding, abstracted data and DRG assignment. + Reviews non-CC/MCC records to determine if the record was… more
- Elevance Health (Seattle, WA)
- **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS- DRG , AP- DRG and APR- DRG )** **Virtual:** This role enables associates to work virtually ... granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure clinical… more
- Highmark Health (Harrisburg, PA)
- …II code and modifier assignments, ICD diagnosis and procedure coding, DRG /APC structure according to regulatory requirements. Reports findings both verbally and ... systems, missed secondary diagnoses and procedures and ensures compliance with DRG /APC structure and regulatory requirements. Performs periodic claim form reviews to… more
- Sharp HealthCare (San Diego, CA)
- …*This is a remote position* **What You Will Do** The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's (SHC's) compliance ... coding or professional E/M coding in the following coding systems: ICD-10-CM/PCS, DRG , CPT& HCPCs, and/or E/M CPT. **Preferred Qualifications** + Other : Strong… more
- Baylor Scott & White Health (Dallas, TX)
- **JOB SUMMARY** The Coding Auditor 1 is proficient in various types of coding and is responsible for performing coding quality audits and providing feedback to ... coders. The Coding Auditor 1 utilizes the International Classification of Disease (ICD-10-CM/PCS),...ensure accurate coding and grouping of classification assignment (eg, MS- DRG , APR- DRG , APC etc.) **ESSENTIAL FUNCTIONS OF… more
- Humana (Springfield, IL)
- …of our caring community and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation ... is complete, compliant and accurate to support optimal reimbursement. The Nurse Auditor 2 work assignments are varied and frequently require interpretation and… more
- Houston Methodist (WA)
- At Houston Methodist, the Coding Quality Auditor position is responsible for ensuring accuracy in code assignment of diagnosis and procedure to outpatient and/or ... **SERVICE ESSENTIAL FUNCTIONS** + Responds promptly to internal and external customer coding/ DRG requests. Responds promptly to Business Office requests to code or… more
- UNC Health Care (Chapel Hill, NC)
- …the state to train and shadow round with Clinical Documentation Specialists. The CDS auditor provides elbow to elbow support during training and education as well as ... severity of illness, and risk of mortality. Assures accurate assignment of Working MS- DRG , ICD-10-CM/PCS codes and CPT codes in accordance with the Official Coding… more
- Stanford Health Care (Palo Alto, CA)
- …is a Stanford Health Care job.** **A Brief Overview** The Charge Auditor performs auditing activities, including complex cases that require extensive research, ... interpretation and application of laws and regulations. Charge Auditor evaluates the adequacy and effectiveness of internal and operational controls designed to… more
- Geisinger (Danville, PA)
- Job Summary The Senior Compliance Auditor ensures the integrity and accuracy of facility and professional compliance audits, monitoring, and provides compliance ... and professional documentation, coding, and billing. The Senior Compliance Auditor serves as a mentor for Compliance Auditors and...the adequacy of medical record documentation to support coding ( DRG , CPT, ICD 10) and billing as required by… more
- Northwell Health (Garden City, NY)
- …position Job Responsibility 1.Leverages clinical expertise to identify and validate DRG code assignment. 2.Full review of CDI suggested code changes 3.Demonstrates ... codes on Medicare/non-Medicare charts for compliance to rules and conventions. 7.Communicates DRG changes and rationale to the coding and CDI staff. 8.Identifies… more
- Datavant (Dover, DE)
- …reviews, using appropriate assignment of codes and other coding-related elements using MS DRG or APR DRGs. + Provides rich and concise rationale explaining the ... and/or auditing. + CCS (preferred), RHIA or RHIT preferred + Maintain 95% DRG accuracy rate + Experience with various software including Epic, Cerner, and other… more