- The Mount Sinai Health System (New York, NY)
- The purpose of DRG validation is to confirm that diagnostic, procedural information, and the discharge status of the beneficiary, as coded and reported by the ... 10th Revision (ICD-10-CM and ICD-10-PCS) codes and the Diagnosis Related Groups ( DRG ). The CRM reviews the physician documentation for specificity, completeness and… more
- Crouse Hospital (Syracuse, NY)
- The DRG Coding Specialist works under the Coding Manager and oversees compliance with coding standards and regulations. Advises and assists in improvement plans ... for coding and DRG assignment issues. Validates assignment of codes and provides...procedures, etc. and the effect of these changes on reimbursement . 3.Proposes and assists in planning and executing appropriate… more
- University of Miami (Hialeah, FL)
- …to ensure accurate clinical documentation in the medical record. The CDI Manager maintains oversight of all phases of the CDI process to ensure compliance, ... + Provides education to the medical staff and the healthcare team regarding clinical documentation opportunities, coding and reimbursement issues, as well as… more
- Trinity Health (Livonia, MI)
- …Must have thorough knowledge of CMS regulations, coding guidelines and DRG reimbursement . Project management and/or system implementation experience required. ... record and supports the patient's severity of illness, risk of mortality, clinical validity and proper DRG assignment. **ESSENTIAL FUNCTIONS** Knows,… more
- Sutter Health (San Francisco, CA)
- …the CDI Coding Quality Liaison Serves as a Diagnosis Related Group ( DRG ) expert, supporting clinical documentation initiatives across their assigned market ... the patient populations served. Subject matter expertise regarding quality and reimbursement implications of clinical documentation and coding. Up-to-date… more
- J&J Family of Companies (Salt Lake City, UT)
- Field Reimbursement Manager , Abiomed - 2406181172W **Description** Abiomed, a member of the Johnson & Johnson Family of Companies, is currently recruiting for a ... Field Reimbursement Manager to be located in the...managements of strategic initiatives within geography. Support sales and clinical teams with reimbursement questions and issues.… more
- Abbott (Tyler, TX)
- …high employer contribution + Tuition reimbursement , the Freedom 2 Save ... \#1 (https://abbotthr.zendesk.com/agent/tickets/1) Spinal cord stimulator on the market, Proclaim (TM) DRG Neurostimulator, the only FDA approved DRG therapy and… more
- Guthrie (Binghamton, NY)
- …CDMP guidelines. 2. Demonstrates knowledge of CDMP guidelines and program, DRG payor issues, documentation opportunities, clinical documentation requirements, ... Summary: Responsible for improving the overall quality and completeness of clinical documentation Facilitates modifications to clinical documentation through… more
- Texas Health Resources (Arlington, TX)
- …each initial review via CareConnect1 or other Utilization Management tool. Discusses working DRG issues as needed with Care Transition Manager 30% **Additional ... **RN/Registered Nurse-Utilization Management, Clinical Reviews** **Work location:** 100% remote but must...solving and decision making. Broad and intimate knowledge of reimbursement and regulatory requirements. Decisive judgment and the ability… more
- UNC Health Care (Chapel Hill, NC)
- …and Wyoming.** Summary: This position trains and audits Inpatient and Outpatient Clinical Documentation Specialists (CDS) across all HCS entities that are owned or ... across the state to train and shadow round with Clinical Documentation Specialists. The CDS auditor provides elbow to...hiring and selection of new CDS with the hiring manager as requested. 6. Analyzes and audits medical records… more
- Hartford HealthCare (Farmington, CT)
- …Collaborates with clinical documentation specialists (CDS) to determine appropriate DRG assignment for compliance and reimbursement purposes. 3. Collaborates ... Leads Inpatient coding team as assigned and backs up manager in their absence. Trains and mentors new and...to assist with backlog as necessary by reviewing inpatient clinical documentation to determine the appropriate assignment of alpha… more
- Hartford HealthCare (Newington, CT)
- …Collaborates with clinical documentation specialists (CDS) to determine appropriate DRG assignment for compliance and reimbursement purposes. 2. Collaborates ... other common practices across the system. *_Position Summary:_* Reviews inpatient clinical documentation to determine the appropriate assignment of alpha numeric… more
- Hartford HealthCare (Farmington, CT)
- …Collaborates with clinical documentation specialists (CDS) to determine appropriate DRG assignment for compliance and reimbursement purposes. 2. Collaborates ... other common practices across the system. *_Position Summary:_* Reviews inpatient clinical documentation to determine the appropriate assignment of alpha numeric… more
- AdventHealth (New Smyrna Beach, FL)
- …for:** AdventHealth New Smyrna Beach **The role you'll contribute:** _The Clinical Social Worker, Licensed, intervenes with patients who have complex psychosocial ... Social Worker, Licensed,_ in collaboration with the patient/family, care manager nurses, nurses, physicians and the interdisciplinary team, ensures patient-centered… more
- Abbott (Los Angeles, CA)
- …partnership with physicians, support staff and Abbott personnel. Stay abreast of and communicate clinical data regarding DRG and SCS products. + Clinical ... retirement savings plan with high employer contribution + Tuition reimbursement , the Freedom 2 Save (https://www.abbott.com/corpnewsroom/strategy-and-strength/tackling-student-debt-for-our-employees.html) student debt program… more
- Hackensack Meridian Health (Hackensack, NJ)
- …+ Apply reason/tracking code and rationale (if needed) in 3M as needed for DRG mismatches on Clinical Documentation Improvement (CDI) reviewed cases. + Provides ... **Coding Quality Auditor** is responsible for monitoring compliance with applicable clinical documentation to support coding and billing regulations to insure… more
- Tidelands Health (Murrells Inlet, SC)
- …integrated system of inpatient records. + Knowledge of MS- DRG and APR DRG classification and reimbursement structures + Understanding of appropriate level of ... the Standards of Ethical Coding as set forth by AHIMA. Abstracting required clinical information from the medical record. Queries physicians as needed, to clarify… more
- Immigration and Customs Enforcement (IN)
- …Responsibilities DUTIES AND RESPONSIBILITIES: Serves in the capacity of Regional Utilization Manager and subject matter expert in the oversight of program activities ... appropriateness of health care and services based on regulatory, reimbursement requirements, evidence-based national care guidelines and evidence-based practices),… more
- Highmark Health (Jefferson City, MO)
- …techniques, medical terminology and disease processes as it relates to the DRG /APC and other clinical data quality management factors. With technical ... II code and modifier assignments, ICD diagnosis and procedure coding, DRG /APC structure according to regulatory requirements. Reports findings both verbally and… more
- AdventHealth (Winter Garden, FL)
- …Manager ensures efficient and cost-effective care through appropriate resources monitoring, and clinical care escalations. The RN Care Manager is under the ... continuum, intervening to remove barriers to timely and efficient care delivery and reimbursement . The RN Care Manager provides education to nurses, physicians… more