- Stanford Health Care (Palo Alto, CA)
- …coding with ICD, HCPCS, CPT codes, as well as APC and DRG assignments, while identifying instances of overpayments and underpayments. Proficiency in healthcare ... groups to successful outcomes. + Knowledge of medical and insurance terminology, MS- DRG , APR- DRG , CPT, ICD coding structures, and billing forms (UB, 1500). +… more
- Stanford Health Care (Palo Alto, CA)
- …CPT (Current Procedural Terminology) codes; evaluates the appropriateness of DRG (Diagnosis-related Group) and admission assignments; evaluates appropriateness of ... work effectively both as a team player and leader + Knowledge of DRG /APC reimbursement + Knowledge of health information systems for computer application to medical… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …of charges. + Validate coding accuracy for CPT, HCPCS, ICD-10-CM, and DRG . + Identify and report coding discrepancies or errors and recommend adjustments ... Skills, and Abilities** + Basic understanding of CPT, HCPCS, ICD-10-CM, and DRG coding. + Strong attention to detail and analytical thinking. + Effective… more
- Conifer Revenue Cycle Solutions (Frisco, TX)
- …Coding Quality : Demonstrates consistency in achieving or exceeding 95.5% coding accuracy in the selection of principal and secondary diagnoses ((including DRG , MCC ... Abides by the Standards of Ethical Coding as set forth by AHIMA. Abstracting required clinical information from the medical record. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. Coding : Reviews medical records for the… more
- Conifer Revenue Cycle Solutions (Frisco, TX)
- …Knowledge of disease pathophysiology and drug utilization Knowledge of MS- DRG classification and reimbursement structures PC/Systems literate including the Internet ... and MS office skills Ability to apply coding conventions, official guidelines, and Coding Clinic advice to health record documentation Management of multiple priorities - effective time management skills Leadership and organizational skills along with… more
- Lyric (Newtown Square, PA)
- …well as an understanding of medical terminology, and prospective payment systems including DRG , OPPS, and MIPS + Creative thinker with an entrepreneurial spirit + ... Strong verbal and written communication skills + Experience in various claim payment methodologies for professional, facility, and ancillary providers + Working knowledge of payment integrity auditing concepts The US base salary range for this full-time… more
- Stony Brook University (Stony Brook, NY)
- …to the Bone Marrow Transplant service. + Ensure procurement charges are coded into DRG . + Record keeping for the purchase and procurement of stem cell, bone marrow, ... cord blood, immune effector cells, and HLA typing. + Review charges with BMT Program Manager and manage care departments for hospital and physician charges accrued. + Report and track yearly budgets for Bone Marrow Transplant Program and Stem Cell Laboratory.… more
- SMBC (New York, NY)
- …competitive portfolio of benefits to its employees. **Role Description** Distribution Risk Group ( DRG ) is seeking a risk management Vice President to play an active ... role in assisting with the risk management of loan and bond underwriting risk and CLO warehouse financing (referred to at SMBC as distribution risk). The group covers distribution risk for the full spectrum of SMBC's products. The individual would support… 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 ... coding and has a high level of understanding of the current MS- DRG , and APR- DRG payment systems. This position is responsible for reviewing medical records for… more
- Elevance Health (Atlanta, GA)
- **Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS- DRG , AP- DRG and APR- DRG )** **Virtual:** This role enables associates to work virtually ... (local time) The **Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS- DRG , AP- DRG and APR- DRG )** is responsible for auditing inpatient medical… more
- 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 ... an episode of care. + Review and evaluate focused UPMC DRG medical records for accurate DRG assignment to ensure that all documented principal and secondary… more
- Zelis (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
- 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
- Elevance Health (Hanover, MD)
- ** 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
- 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
- Zelis (NJ)
- …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 Coding… 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
- 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
- Insight Global (Plano, TX)
- Job Description Insight Global is seeking experienced DRG Auditors to join a remote healthcare organization. The DRG Revenue Integrity Auditor will perform ... Diagnostic Related Group ( DRG ) validation and quality audits on inpatient charts to...acute care setting or a third-party vendor as a DRG Auditor or Clinical Documentation Specialist (CDS). Prior experience… more
- HCA Healthcare (Nashville, TN)
- …with purpose and integrity. We care like family! Jump-start your career as a DRG Validation Auditor today with Parallon. **This position is a fully work from home ... position.** **Schedule: Monday-Friday Day Shift** **This position requires DRG Validation and Inpatient Coding experience.** **Benefits** Parallon, offers a total… more
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