- Elevance Health (Chicago, IL)
- ** DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ __ This role enables associates to work virtually full-time, with the exception of required in-person ... 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)
- …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
- Elevance Health (Denver, CO)
- … 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 (CDI, MS- DRG , AP- DRG ...+ Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance… more
- Insight Global (South Jordan, UT)
- Job Description Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100% remote. This person should have an extensive background in ... reviews of medical records and other documentation to evaluate issues of coding and DRG assignment accuracy. Below are the key responsibilities for this role:… 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....discharge disposition, and any other relevant data to ensure coding accuracy. The auditor is also responsible… more
- Humana (Boise, ID)
- …of our caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and ... (eg, ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex...least one of these qualifications for 4 years) * MS- DRG coding /auditing experience * Experience reading and… more
- Highmark Health (Nashville, TN)
- …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
- AdventHealth (Altamonte Springs, FL)
- …Location** : Remote **The role you will contribute:** The inpatient or outpatient coding team Corporate Quality Auditor (QA)/Educator supports the operations of ... Health Information Technician Required **Preferred Qualifications:** 5 of inpatient or outpatient coding or Coding Quality Auditor experience Preferred This… more
- Houston Methodist (Houston, TX)
- 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… more
- HCA Healthcare (Caldwell, ID)
- …you to apply! **Job Summary and Qualifications** As a work from home Inpatient Coding Auditor , you will be responsible for performing internal quality assessment ... of each individual is recognized. Submit your application for the opportunity below: Inpatient Coding Quality Auditor Parallon. **This is a fully work from home… more
- Avera (Sioux Falls, SD)
- …information management departments and billing offices with ICD-10, CPT, and HCPCS coding review, DRG and APC reimbursement, and coordination of information ... between medical record and billing departments. A successful Auditor assists in the organization and presentation of educational workshops and seminars for Avera,… 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
- 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 ... analysis to determine specific training needs for clinical and coding staff + Identifies, selects, or develops appropriate training...degree in Nursing or equivalent experience. 4+ years of DRG and/or Medical Record Audit experience. One year of… more
- Cognizant (Nashville, TN)
- **About the role** As an Inpatient Medical Coding Auditor , you will make an impact by auditing consultant inpatient. You will be a valued member of the Cognizant ... and ICD-10-PCS education and mentoring to Company's clients in coding , billing and compliance + Perform Peer Reviews of...+ CCS, RHIT or RHIA (AHIMA) certification + APR DRG experience + Minimum of five years of facility-based… 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
- AdventHealth (Orlando, FL)
- …+ Performs quality reviews on coded records to validate ICD-10, ICD-10-PCS, MS- DRG , APR-DRGs, and overall coding accuracy retrospectively and concurrently. + ... each year **The role you'll contribute:** Under the general supervision of the Coding Quality Manager, the Data Quality Reviewer is responsible for validating the … 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
- 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
- Premera Blue Cross (Mountlake Terrace, WA)
- …**Knowledge, Skills, and Abilities** + Basic understanding of CPT, HCPCS, ICD-10-CM, and DRG coding . + Strong attention to detail and analytical thinking. + ... documentation to verify coding accuracy and appropriateness of charges. + Validate coding accuracy for CPT, HCPCS, ICD-10-CM, and DRG . + Identify and report… more
- UPMC (Pittsburgh, PA)
- …(BSN). + Five years of clinical experience. + Two years of either HCC coding , reviews or education, DRG experience, Clinical Documentation Improvement, Fraud & ... has an exciting opportunity for a Risk Adjustment Clinical Auditor /Analyst position in the Medicare department. This is a...are supported within the audit year, and utilize AHA Coding clinics, ICD-10-CM Coding Guidelines, CPT … more