- Christus Health (Woodworth, LA)
- …of clinical severity and services rendered to patients with a DRG based payer (Medicare, Medicaid). Supports timely, accurate and complete documentation ... a complete reflection of the patient's clinical status and care Maintain a DRG worksheet to assist coders on identifying all documented POA/HAC, diagnosis and… more
- Christus Health (Beaumont, TX)
- …medical records. The clinical documentation RN will facilitate accurate DRG assignment and obtain appropriate documentation through extensive interaction with ... reflection of the patient's clinical status and care Maintains an electronic DRG worksheet to assist coders on identifying all documented diagnosis and procedures… more
- Bayer (Whippany, NJ)
- …sales data sources such as sales/claims (eg, IQVIA, Symphony), access (eg, DRG , MMIT), Patient Services data, Specialty Pharmacy data, formulary data, etc. Ability ... to see the “big picture” to work with the associated data experts to stitch data together to drive strategic analytics; Strong verbal and written communication skills; Demonstrated thought leadership skills operating within cross- functional teams in a matrix… more
- Christus Health (San Antonio, TX)
- …for PAN referrals. Proactively uses 3M report which assigns working MS/APR DRG in MIDAS daily, and queries, communicates and collaborates with nursing, physicians, ... and other healthcare professionals daily related to length of stay (LOS). Adheres to MCG process for documentation per training. Documents delays of care and readmits appropriately and timely to develop potential trends and improved interventions. Payer… more
- Stanford Health Care (Palo Alto, CA)
- …billing + Knowledge of charge capture workflows and CDM + Knowledge of DRG /APC reimbursement + Knowledge of health information systems for computer application to ... medical records + Knowledge of ICD-10-CM & CPT coding conventions to code medical record entries; abstract information from medical records; read medical record notes and reports; set accurate Diagnostic Related Groups + Knowledge of standards and regulations… more
- Elevance Health (Richmond, VA)
- …Make an Extraordinary Impact.** **Title** : Diagnosis Related Group Clinical Validation Auditor (CDI, MS- DRG , AP- DRG and APR- DRG ) **Virtual: ** _ _ This ... reside within a commuting distance from an office.** The ** DRG Coding Auditor** is responsible for auditing inpatient medical...and other documentation to evaluate issues of coding and DRG assignment accuracy. Specializes in review of DRG… more
- Elevance Health (Roanoke, VA)
- ** DRG Coding Auditor Principal** **_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 Principal** is responsible for auditing inpatient medical… 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
- 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
- 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
- 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
- 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
- Elevance Health (Chicago, IL)
- **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
- University of Michigan (Ann Arbor, MI)
- DRG COMPLIANCE AUDITOR (DCA) Apply Now **Job Summary** Review and check certain inpatient records to make sure the coding is correct and follows rules for ICD-10 ... codes. This includes checking the DRG groups, Present on Admission indicators, Severity of Illness,...documents to decide what information is needed for accurate DRG , POA, SOI, and ROM scores. + Communicate effectively… more
- Elevance Health (Hanover, MD)
- Manager of DRG Coding Audit-Program/Project Locations: _The selected candidate must reside within a reasonable commuting distance of the designated posting ... recover, eliminate and prevent unnecessary medical-expense spending. The **Manager of DRG Coding Audit** leads a high-performing team responsible for auditing… 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
- University of Utah Health (Salt Lake City, UT)
- …position audits the accuracy and completeness of diagnosis and procedure coding, DRG assignment, and abstracted data to support that appropriate reimbursement and ... audits the accuracy and completeness of diagnoses, procedure coding, abstracted data and DRG assignment. + Reviews non-CC/MCC records to determine if the record was… more
- WMCHealth (Valhalla, NY)
- DRG Validator Company: NorthEast Provider Solutions Inc. City/State: Valhalla, NY Category: Clerical/Administrative Support Department: Health Info Mgmt-WMC Health ... (https://pm.healthcaresource.com/cs/wmc1/#/preApply/31147) Internal Applicant link Job Details: Job Summary: The DRG Validator will be responsible for coding reviews for… more
- UTMB Health (Galveston, TX)
- Senior DRG Coder - RCO Coding **Galveston, Texas, United States** **Hot** Business, Managerial & Finance UTMB Health Requisition # 2506522 **Minimum Qualifications** ... 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
Related Job Searches:
DRG Auditor,
DRG Coding Auditor,
DRG Coding Auditor Principal,
DRG Reviewer,
Facility Coding Inpatient DRG,
Inpatient DRG Coding Auditor,
Inpatient DRG Quality Auditor,
Inpatient Medical DRG Coder,
Manager DRG Coding Validation,
RN Lead DRG Coding