- 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 (Chicago, IL)
- ** 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
- Elevance Health (Denver, CO)
- …(CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC. + ... **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS- DRG , AP- DRG ...Experience with third party DRG Coding and/or Clinical Validation Audits or… 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 ... discharge disposition, and any other relevant data to ensure coding accuracy. The auditor is also responsible...coding practices and compliance. **Essential Functions** + Performs inpatient denial reviews using ICD-10-CM/PCS and DRG … more
- Insight Global (South Jordan, UT)
- … knowledge ( DRG & ICD-10) Registered Nurse RN (must be inpatient ) WITH coding /clinical documentation certification (2 years in clinical documentation) OR ... Job Description Insight Global is seeking a DRG Validation Auditor for one of...extensive background in either facility-based nursing, clinical documentation, and/or inpatient coding and has a high level… more
- Humana (Boise, ID)
- …of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical ... caring community and help us put health first** The Inpatient Medical Coding Auditor extracts...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 ... Health Network **Job Description :** **_*This role will cover Inpatient Auditors and will require Inpatient (AHIMA)...In-depth knowledge of ICD CM, ICD PCS and CPT/HCPCS coding systems. Must be proficient in DRG /APC… more
- HCA Healthcare (Caldwell, ID)
- …We want you to apply! **Job Summary and Qualifications** As a work from home Inpatient Coding Auditor , you will be responsible for performing internal ... is recognized. Submit your application for the opportunity below: Inpatient Coding Quality Auditor Parallon....a fully work from home position.** **This position requires Inpatient Coding and DRG Validation… 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 ... teams. **In this role, you will:** + Review ICD-10 inpatient patient records for accuracy and compliance + Review...and ICD-10-PCS education and mentoring to Company's clients in coding , billing and compliance + Perform Peer Reviews of… more
- AdventHealth (Orlando, 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)
- …: Remote **The role you will contribute:** The inpatient or outpatient coding team Corporate Quality Auditor (QA)/Educator supports the operations of the ... + Expert level knowledge of Medicare Severity Diagnosis-Related Groups (MS- DRG ), and All Patient Refined Diagnosis-Related Groups (APR ...**Preferred Qualifications:** 5 of inpatient or outpatient coding or Coding Quality Auditor … 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
- 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 (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. ... **Req Number** 155044 Job Description Validates Acute Inpatient coded charts to ensure the diagnostic information leading to the assignment can be substantiated by… more
- UPMC (Pittsburgh, PA)
- …Modifiers, etc.). + Knowledge of coding /classification systems appropriate for inpatient /outpatient, DRG prospective payment system or office setting E/M ... auditing, billing and compliance. + Knowledge of CMS and third-party payer coding , billing, and documentation compliance regulations preferred (MS- DRG , APR-… more
- UPMC (Pittsburgh, PA)
- …Modifiers, etc.). + Knowledge of coding /classification systems appropriate for inpatient /outpatient, DRG prospective payment system or office setting E/M ... auditing and compliance. + Extensive knowledge of CMS, and third-party payer coding , billing, and documentation compliance regulations required (MS- DRG , APR-… more
- UPMC (Pittsburgh, PA)
- …rules. Accurately review the assigned HCC diagnosis codes and apply the appropriate inpatient or outpatient coding guidelines, AHA coding clinics, ICD-10-CM ... has an exciting opportunity for a Risk Adjustment Clinical Auditor /Analyst position in the Medicare department. This is a...of clinical experience. + Two years of either HCC coding , reviews or education, DRG experience, Clinical… more
- Molina Healthcare (Iowa City, IA)
- …all claim types of reimbursements not limited to payment methodologies such Stoploss, DRG , APC, RBRVS, FFS applicable for HD Inpatient , Outpatient and ... and services billed under Institutional and non-institutional claims. * Validates coding , updating and maintaining benefit plans, provider contracts, fee schedules… more
- Houston Methodist (Houston, TX)
- …(for inpatient /outpatient coding ) coding classification systems + For inpatient /outpatient coding : MS- DRG , APR DRG and APC assignment systems ... professional teaching/training experience **LICENSES AND CERTIFICATIONS - REQUIRED** + For inpatient /outpatient coding : RHIT, RHIA, or CCS certification from… more