- UNC Health (Chapel Hill, NC)
- …the unique communities we serve. Summary: This positon trains and audits Inpatient and Outpatient Clinical Documentation Specialists (CDS) across all HCS entities ... 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
- Zelis (FL)
- …gained, and the personal interests that shape who you are. Position Overview The Inpatient DRG Reviewer will be primarily responsible for conducting ... post-service, pre-payment and post pay comprehensive inpatient DRG reviews based on...Clinic and client specific coverage policies. Conduct prompt claim review to support internal inventory management to achieve greatest… more
- Zelis (NJ)
- …this role is responsible for conducting post-service, pre-payment and post pay comprehensive inpatient DRG Quality Assurance reviews in an effort to increase the ... savings achieved for Zelis clients. Conduct reviews on inpatient DRG claims as they compare with medical records utilizing ICD-10 Official Coding Guidelines, AHA… 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 encounters ... the accuracy of DRGs. This individual will: + Reviews inpatient medical records for select payer populations post-discharge and...nursing, and other clinical staff to improve documentation. + Review ?s DRG Reassignment letters and assists… 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 ... to improve coding practices and compliance. **Essential Functions** + Performs inpatient denial reviews using ICD-10-CM/PCS and DRG validation utilizing… more
- Insight Global (Dothan, AL)
- Job Description Insight Global is hiring Inpatient Coding Specialists for a healthcare client located in Dothan, AL. In this role, the Inpatient Coding ... we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/. Skills and… more
- University of Michigan (Ann Arbor, MI)
- …Related Group, (MS- DRG ) or All Patient Refined Diagnosis Related Group, (APR- DRG .) + The Inpatient Coding Specialist is responsible for verification of ... Medical Coder Inpatient Apply Now **Job Summary** Advanced coding position...Apply Now **Job Summary** Advanced coding position that requires review of medical record documentation and accurately assigns ICD-10-CM,… more
- Datavant (Annapolis, MD)
- …allowing you to help shape the future of healthcare from your own workspace! Seeking Inpatient Auditor proficient in MS- DRG and APR- DRG **What You Will Do:** ... function and decision making + Strong organizational, teamwork, and leadership skills Seeking Inpatient Auditor proficient in MS- DRG and APR- DRG **What You… more
- CareFirst (Baltimore, MD)
- …(all benefits/incentives are subject to eligibility requirements). **Department** Inpatient DRG Telephonic **Equal Employment Opportunity** CareFirst ... Navigator (RN) embedded at a partnering hospital will conduct concurrent review of inpatient level of care, managing the timely and smooth transition from… more
- CareFirst (Washington, DC)
- …(all benefits/incentives are subject to eligibility requirements). **Department** Inpatient DRG Telephonic **Equal Employment Opportunity** CareFirst ... Navigator (RN) embedded at a partnering hospital will conduct concurrent review of inpatient level of care, managing the timely and smooth transition from… more
- TEKsystems (Dallas, TX)
- …so they would like for everyone to have experience in emergency services, inpatient coding, or DRG (diagnosis-related group) coding. This would allow them ... MCMC. Then they pass it off to QA for review . They will do these cases over and over...guaranteed Certified Coding Specialist CCS) Experience or exposure to inpatient coding, emergency services coding or DRG … more
- CareFirst (Baltimore, MD)
- …(all benefits/incentives are subject to eligibility requirements). **Department** Inpatient DRG Telephonic **Equal Employment Opportunity** CareFirst ... County/Washington DC or Northern Virginia metropolitan area.** **PURPOSE:** The Inpatient Management Care Management Supervisor will direct and coordinate the… more
- Excellus BlueCross BlueShield (Rochester, NY)
- Job Description: Summary: The Payment Integrity DRG Coding & Clinical Validation Analyst position has an extensive background in acute facility-based clinical ... documentation, and/or inpatient coding and has a high level of understanding of the current MS- DRG , and APR- DRG payment systems. This position is responsible… more
- Elevance Health (Roanoke, VA)
- …spending. The ** DRG Coding Auditor Principal** is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group ( DRG ... all lines of business, and its clients. Specializes in review of DRG coding via medical record...where additional recoveries may be available, such as re-admissions, Inpatient to Outpatient, and Hospital Acquired Conditions (HACs), Preventable… 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 IF ... Job Description Insight Global is seeking a DRG Validation Auditor for one of our clients...extensive background in either facility-based nursing, clinical documentation, and/or inpatient coding and has a high level of understanding… more
- Hartford HealthCare (Farmington, CT)
- …is responsible for reviewing, analyzing and appealing denials related to DRG (Diagnostic Related Group) downgrades. This role involves validating the coding ... address payer concerns. Key responsibilities include timely investigation of DRG downgrades, submitting appeals, coordinating follow-up actions and ensuring… more
- Elevance Health (Washington, DC)
- …clinical documentation supports the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group ( DRG ) paid claims. **How you will ... **Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS- DRG , AP- DRG and APR- DRG )** **Virtual:** This role enables associates to work virtually… more
- HCA Healthcare (Nashville, TN)
- …personal growth, we encourage you to apply for our Coding Quality Audit Reviewer opening. We promptly review all applications. Highly qualified candidates will ... We care like family! Jump-start your career as a DRG Validation Auditor today with Parallon. **Benefits** Parallon offers...Come join our team as a Coding Quality Audit Reviewer . We care for our community! Just last year,… more
- WMCHealth (Valhalla, NY)
- …in working with multiple computer applications and EMR systems. Responsibilities: + Review diagnostic, procedural and DRG assignments for validity and accuracy. ... DRG Validator Company: NorthEast Provider Solutions Inc. City/State:...have a minimum of 5 years' experience specializing in inpatient . Education: Bachelor's degree in a health related field,… more
- UTMB Health (Galveston, TX)
- …**Minimum Qualifications** High school or equivalent and three years of experience. The Sr. DRG coder must be proficient in inpatient coding with the ability to ... coding of all pertinent diagnoses and procedures and to provide optimal DRG assignment after thorough review of medical record and analysis of DRG options.… more
