- UPMC (Pittsburgh, PA)
- UPMC Corporate Revenue Cycle is hiring a DRG Specialist to work on inpatient auditing within our Coding Department. This position will be a work-from-home position ... OIG regulations. **Responsibilities:** + Review and evaluate focused UPMC DRG medical records for accurate DRG assignment...focused UPMC DRG medical records for accurate DRG assignment to ensure that all documented principal and… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …leadership programs and more! **Description** We are seeking an experienced **Inpatient DRG Coding Auditor** to extract data from patient encounters ensuring the ... the accuracy and completeness of diagnosis and procedure coding, DRG assignment, and abstracted data POA, Discharge Disposition. +...+ Reviews discrepancies between the Clinical Documentation Specialist (CDS) DRG and the Coder DRG . + Reviews… more
- Zelis (St. Petersburg, FL)
- …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 industry standard inpatient coding guidelines...criteria plan, and policy exclusions. Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10… more
- UPMC (Pittsburgh, PA)
- UPMC Corporate Revenue Cycle is hiring a DRG Specialist II to join our coding team! This opportunity works Monday through Friday during daylight hours. The position ... will be fully remote! In this role, the DRG Specialist II will review clinical documentation within the...episode of care. + Review and evaluate focused UPMC DRG medical records for accurate DRG assignment… 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 ... of understanding of reimbursement guidelines specifically an understanding of the MS- DRG , AP- DRG , and APR- DRG payment systems. This position is responsible… more
- Banner Health (AR)
- …quality in the Inpatient Facility Coding department. If you have experience with DRG and PCS coding/denials/audits, we want to hear from you. **Requirements:** + **5 ... facility-based medical coding (clearly reflected in your attached resume);** + ** DRG and PCS Coding, Auditing experience;** + **Bachelors degree or equivalent;**… more
- Elevance Health (Richmond, VA)
- ** DRG CODING AUDITOR** **_Virtual_** **_: _** _ _ __ This role enables associates to work virtually full-time, with the exception of required in-person training ... determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** DRG CODING AUDITOR** is responsible for auditing inpatient medical records… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The purpose of DRG validation is to confirm that diagnostic, procedural information, and the discharge status of the beneficiary, as coded and ... 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
- Elevance Health (Hanover, MD)
- **Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS- DRG , AP- DRG and APR- DRG )** **Virtual:** This role enables associates to work virtually ... and reimbursed. Specializes in review of Diagnosis Related Group ( DRG ) paid claims. **How you will make an impact:**...minimum of 5 years of experience working with ICD-9/10CM, MS- DRG , AP- DRG and APR- DRG ; or… more
- Elevance Health (Roanoke, VA)
- **Manager DRG Coding Validation (Manager Program and Project Management)** **** **Hybrid 2:** This role requires associates to be in-office **3** days per week, ... recover, eliminate and prevent unnecessary medical-expense spending. The Manager of DRG Coding Audit & Clinical Validation leads a high-performing team responsible… more
- Kaleida Health (Buffalo, NY)
- **Director Clinical and DRG Denials** **Location:** Larkin Bldg @ Exchange Street Location of Job: US:NY:Buffalo Work Type: Full-Time **Shift:** Shift 1 Job ... Description **Summary:** The Director, Clinical & DRG Denials provides clinical leadership and administrative guidance to the Clinical Revenue Cycle department.… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** We are looking for a Revenue Integrity DRG Auditor who has a comprehensive understanding of hospital Revenue Cycle Management. Significant ... experience in the following areas: hospital inpatient coding, DRG assignment, charge capture, and hospital reimbursement methodologies. The candidate must have… 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. This includes evaluating present on admission (POA) indicators, discharge… more
- UTMB Health (Galveston, TX)
- Senior DRG Coder - Revenue Cycle Coding **Galveston, Texas, United States** **Hot** Business, Managerial & Finance UTMB Health Requisition # 2504141 **Minimum ... or equivalent and three years of experience. The Sr. DRG coder must be proficient in inpatient coding with...all pertinent diagnoses and procedures and to provide optimal DRG assignment after thorough review of medical record and… more
- Hartford HealthCare (Farmington, CT)
- …2 is responsible for reviewing, analyzing, and appealing denials related to DRG (Diagnostic Related Group) validation denials. This role involves validating the ... address payer concerns. Key responsibilities include timely investigation of DRG downgrades, submitting appeals, coordinating follow-up actions, and ensuring… more
- Hartford HealthCare (Farmington, CT)
- …alpha numeric diagnosis/procedure codes and Medicare Severity Diagnosis Related Groups (MS- DRG ). Data is classified for internal and external statistical reporting, ... and/or encoder, coding manuals and other reference material. 3. Reviews DRG assigned to each record. Enters coded/abstracted information into software, analyzes… more
- Humana (Hartford, CT)
- …expertise in Medicaid reimbursement methodologies rooted in complex grouping concepts (EAPG, APR- DRG , MS- DRG , etc). This role is within the Integrated Network ... for hospitals and facilities + Developing expertise in complex groupers (EAPG, APR- DRG , MS- DRG , etc) utilized in Medicaid reimbursement + Reviewing Medicaid… more
- Trinity Health (Livonia, MI)
- …and secondary procedures. Assigns appropriate Medicare Severity Diagnosis Related Groups (MS- DRG ), All Patient Refined DRGs (APR), Present on Admission (POA), as ... of Diseases, Clinical Modification (ICD-CM) diagnosis and procedure codes, MS- DRG , APR DRG , POA, SOI & ROM assignments. ESSENTIAL FUNCTIONS: 1. Knows,… more
- Marshfield Clinic (Marshfield, WI)
- …Uniform Hospital Discharge Data Set (UHDDS) and assignment of the appropriate MS- DRG (Medicare Severity-Diagnosis Related Group) or APR- DRG (All Patients Refined ... co-morbidities and complications, secondary conditions, surgical procedures and/or other procedures. + MS- DRG /APR- DRG + Present on admission indicators + HAC… more
- RWJBarnabas Health (Oceanport, NJ)
- …responsible for ensuring accuracy and integrity of ICD-10-CM/PCS coding and DRG assignment for inpatient encounters for other payers (not Medicare/Managed Medicare). ... the accuracy and integrity of ICD-10-CM/PCS, CPT coding when applicable and DRG assignment for adherence to Federal and State Regulations and Compliance Guidelines.… more
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