- Elevance Health (Tampa, FL)
- ** DRG CODING AUDITOR ** **Location** : _This position will work virtually._ _Alternate locations may be considered._ The ** DRG CODING AUDITOR ** is ... coding and DRG assignment accuracy. Specializes in review of DRG coding via medical record and attending physician's statement sent in by acute care… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …development, leadership programs and more! **Description** We are seeking an experienced **Inpatient DRG Coding Auditor ** to extract data from patient ... coding ICD-10 in an acute care setting. + Previous experience in performing DRG coding audits. + Possesses knowledge of DRG and grouping methodologies (MS… more
- Hackensack Meridian Health (Hackensack, NJ)
- …includes compliance with the Conditions of Participation for CMS. The DRG auditor is responsible for ensuring coding accuracy, coding consistency and ... a leader of positive change. The **Diagnosis Related Group ( DRG ) Auditor ** is responsible for auditing clinical...Management (HIM) education. + Minimum of 5 years progressive coding review in ICD-10-CM and DRG methodologies.… more
- TEKsystems (Jacksonville, FL)
- Remote Inpatient Coding Auditor (Full Time & PRN Openings)...* Must have 5+ years of experience with Inpatient Coding Auditing. * Must be strong in DRG , ... professionalism, and progress. We are hiring 1 Remote Inpatient Coding Auditor who is passionate about ...Coding references will be used to ensure accurate coding and grouping of classification assignments (eg, MS- DRG… more
- Highmark Health (Columbus, OH)
- …HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding , DRG /APC structure according to regulatory requirements. Reports findings both ... Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or physician...In-depth knowledge of ICD CM, ICD PCS and CPT/HCPCS coding systems. Must be proficient in DRG /APC… more
- Houston Methodist (Nashville, TN)
- ** Coding Quality Auditor - 100% Remote (Must Live in FL, TN, GA, LA, WA State, or TX)** **$5,000 Sign-On Bonus** At Houston Methodist, the Coding Quality ... **SERVICE ESSENTIAL FUNCTIONS** + Responds promptly to internal and external customer coding / DRG requests. Responds promptly to Business Office requests to code… more
- TEKsystems (Atlanta, GA)
- …experience in APR, SOI (severity of illness), and ROM (risk of mortality) Description + The Coding Auditor 1 is proficient in various types of coding and is ... quality audits and providing feedback to coders. + The Coding Auditor 1 utilizes the International Classification...Coding references will be used to ensure accurate coding and grouping of classification assignments (eg, MS- DRG… more
- Baylor Scott & White Health (Columbus, OH)
- **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...Coding references will be used to ensure accurate coding and grouping of classification assignment (eg, MS- DRG… 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 ... shared services. This position reports to the HCS Supervisor Coding and CDI Quality and Training. This position may...and shadow round with Clinical Documentation Specialists. The CDS auditor provides elbow to elbow support during training and… more
- AdventHealth (Altamonte Springs, FL)
- …timely clinical documentation.** + **Assists with writing compelling appeals to all DRG denials from outside agencies referencing Official Coding Guidelines and ... Coding Clinic advice as appropriate to defend the DRG assignment and protect the organization's reimbursement.** + **Serves as a resource to other departments in… more
- Northwell Health (Westbury, 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. ... BSN or MSN candidates with a HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist-Clinical. Job Responsibility 1.Leverages clinical… more
- UPMC (Pittsburgh, PA)
- …auditing, billing and compliance. + Knowledge of CMS and third-party payer coding , billing, and documentation compliance regulations preferred (MS- DRG , APR- ... APC, APG or ICD10-CM, HCPCS, CPT, Modifiers, etc.). + Knowledge of coding /classification systems appropriate for inpatient /outpatient, DRG prospective payment… more
- Elevance Health (Norfolk, VA)
- … Credential such as CCS or CIC. + Experience with third party DRG Coding and/or Clinical Validation Audits or hospital clinical documentation improvement ... **Diagnosis Related Group Clinical Validation Auditor -RN** **Location:** This position will work a hybrid...and reimbursed. Specializes in review of Diagnosis Related Group ( DRG ) paid claims. **How you will make an impact:**… more
- UPMC (Pittsburgh, PA)
- …auditing and compliance. + Extensive knowledge of CMS, and third-party payer coding , billing, and documentation compliance regulations required (MS- DRG , APR- ... APC, APG or ICD10-CM, HCPCS, CPT, Modifiers, etc.). + Knowledge of coding /classification systems appropriate for inpatient /outpatient, DRG prospective payment… more
- UPMC (Pittsburgh, PA)
- …auditing and compliance. + Extensive knowledge of CMS, and third-party payer coding , billing, and documentation compliance regulations required (MS- DRG , APR- ... APC, APG, or ICD10-CM, HCPCS, CPT, Modifiers, etc.). + Knowledge of coding /classification systems appropriate for inpatient /outpatient, DRG prospective payment… more
- Catholic Health (Kenmore, NY)
- …flex JOB SUMMARY: The Catholic Health (CH) Health Information Management (HIM) Educator/ Auditor will work cooperatively with CH coding associates, physicians, ... well as updates to the Medicare, New York and APR- DRG grouper logic. The Educator will provide mentoring for...grouper logic. The Educator will provide mentoring for new coding staff. The Educator/ Auditor will also assist… more
- R1 RCM (Detroit, MI)
- …- one that promotes patient satisfaction and improves financial performance. As our DRGV Auditor II, your primary role will be auditing inpatient cases for DRG ... systems to validate the accounts. Opportunity for growth includes a client facing Lead Auditor role and an internally facing Mentor role. **Every day in this role… more
- Prime Healthcare (Ontario, CA)
- …assigned by the Coders or Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software. The Outpatient Coder Auditor Trainee finalizes the ... the clinical documentation of the respective medial record. Holding a senior coding position, assumes primary responsibility for DRG validation/accuracy, primary… more
- University of Texas Rio Grande Valley (Mcallen, TX)
- …Knowledge of Current Procedural Terminology ( CPT ) and Diagnosis Related Group ( DRG ) coding . Knowledge of medical, billing and coding terminology ... Position Information Posting NumberSRGV8219 Working TitleCOMPLIANCE CODING AND BILLING ANALYST Number of Vacancies1 LocationMcAllen, Texas DepartmentOffice of the… more
- R1 RCM (Detroit, MI)
- …analytics, AI, intelligent automation, and workflow orchestration. As our **Clinical Coding Appeals Nurse** , you will help review and interpret medical ... day you will review medical records to ensure appropriate coding of removed or revised diagnosis and procedure codes....underpaid claims. + Apply clinical judgment and knowledge for DRG downgrades performed because of a Clinical Validation Review… more