- CoxHealth (Lake Spring, MO)
- …closely with the CDI Manager, CDI Supervisor, CDI Team Lead, CDI Specialists, Medical Director- Coding /CDI, Inpatient Coding Supervisor and Team Leaders of ... and provides requested feedback for the following Committees: 1) Coding and Documentation Committee 2) Utilization Review ...5) Other Educational meetings as assigned by CDI Manager, Medical Director, Coding /CDI and System Director, … more
- Centene Corporation (Helena, MT)
- …CANDIDATE WILL HAVE DRG CODING EXPERIENCE **Position Purpose:** Perform clinical/ coding medical claim review to ensure compliance with coding ... flexibility. POSITION IS REMOTE CANDIDATE WILL REVIEW INPATIENT DRG 'S IDEAL...directives, precedent, AMA and CMS code edit criterion + Review medical records to ensure billing is… more
- UPMC (Pittsburgh, PA)
- …were performed during an episode of care. + Review and evaluate focused UPMC DRG medical records for accurate DRG assignment to ensure that all ... hours Monday through Friday. In this role, you will review clinical documentation within the medical record... selection; OR specific knowledge as a consultant in Medical Record coding and DRG … more
- Elevance Health (Hanover, MD)
- …of coding and DRG assignment accuracy. Specializes in review of DRG coding via medical record and attending physician's statement sent in by ... Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The ** DRG CODING ...eliminate and prevent unnecessary medical -expense spending. The ** DRG CODING AUDITOR** is responsible for auditing… more
- Zelis (FL)
- …policy exclusions. Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10 Official Coding Guidelines, AHA Coding Clinic and ... that shape who you are. Position Overview The Inpatient DRG Reviewer will be primarily responsible for...and billing rules + Clinical skills to evaluate appropriate Medical Record Coding + Experience conducting root… more
- RWJBarnabas Health (Oceanport, NJ)
- …+ Critically analyzes each Medicare inpatient medical record to apply appropriate coding , DRG judgements, SOI, ROM and POA. + Independently manages SMART ... queues for all acute care RWJBarnabas facilities. Reviews ICD-10-CM/PCS coding and DRG assignment of medical...goals are met for all RWJBarnabas facilities. + May review ICD-10-CM/PCS coding associated with RAC audits… more
- RWJBarnabas Health (Oceanport, NJ)
- …Guidelines. + Critically analyzes each inpatient medical record to apply appropriate coding , DRG judgements, SOI, ROM and POA. + Independently manages SMART ... queues for all acute care RWJBarnabas facilities. Reviews ICD-10-CM/PCS coding and DRG assignment of medical...+ Maintains proper computer and written records of all review activity. + Effectively communicates coding recommendations… more
- Zelis (NJ)
- …clients. Conduct reviews on inpatient DRG claims as they compare with medical records utilizing ICD-10 Official Coding Guidelines, AHA Coding Clinic ... evidence supplied by the provider in the form of medical records such as physician notes, lab tests, images...conduct training for new team members + Identify new DRG coding concepts to expand the … more
- HCA Healthcare (Overland Park, KS)
- …coding guidelines and policy + Demonstrates and applies expert level knowledge of medical coding practices and concepts + Participates on special reviews or ... join an organization that invests in you as a Coding Quality Audit Reviewer ? At Parallon, you...work from home!** **Schedule: Monday-Friday Day Shift** **Must have DRG Validation experience and Inpatient Coding experience**… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …minimal direction or oversight. . Acts as an expert in reviewing medical coding and medical record review with ability to oversee complex assignments, ... Job Description: Summary: The Payment Integrity DRG Coding & Clinical Validation Analyst...I . Analyzes and audits acute inpatient claims. Integrates medical chart coding principles, clinical guidelines, and… more
- Molina Healthcare (Caldwell, ID)
- …years clinical nursing experience in claims auditing, quality assurance, recovery auditing, DRG /clinical validation, utilization review and/or medical claims ... JOB DESCRIPTION Job Summary The RN Lead, DRG Coding /Validation provides lead level support...concepts and or process improvements, tools, etc. * Integrates medical chart coding principles, clinical guidelines, 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 ... nursing, and other clinical staff to improve documentation. + Review ?s DRG Reassignment letters and assists...an acute care setting. + Previous experience in performing DRG coding audits. + Possesses knowledge of… more
- Penn Medicine (Lititz, PA)
- …regulations, and accuracy for clinical care analysis and provider profiling. Review coded medical records for coding and DRG accuracy by verifying that ... cross training to existing staff as needed. + Research, review and respond to coding and ...Identify and communicate documentation issues and concerns that influence coding , DRG assignment, and severity of illness… more
- Carle Health (Urbana, IL)
- …+ Reviews and follows up on all PRO/Insurance review correspondence related to medical record documentation and coding . + Reviews all DRG changes/denials ... Overview The Health Information Management Coding Manager provides day-to-day oversight, direction and management...principle and secondary procedures, and assignment of the working DRG . + Manages HIM physician advisors to ensure flow… more
- HCA Healthcare (Nashville, TN)
- …growth, we encourage you to apply for our Coding Quality Audit Reviewer opening. We promptly review all applications. Highly qualified candidates will be ... coding guidelines and policy + Demonstrates and applies expert level knowledge of medical coding practices and concepts + Participates on special reviews or… more
- Elevance Health (Atlanta, GA)
- … Credential such as CCS or CIC. + Experience with third party DRG Coding and/or Clinical Validation Audits or hospital clinical documentation improvement ... Auditor-RN (CDI, MS- DRG , AP- DRG and APR- DRG )** is responsible for auditing inpatient medical ...the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group ( DRG ) paid… more
- Insight Global (South Jordan, UT)
- …provider billing guidelines, payer reimbursement policies, medical necessity criteria, and coding terminology. Expert coding knowledge ( DRG & ICD-10) ... records and other documentation to evaluate issues of coding and DRG assignment accuracy. Below are...NOT A NURSE: Degree in RHIM, RHIA, RHIT with medical coding degree or just CCS is… more
- Community Health Systems (Franklin, TN)
- …policies and standards. **Qualifications** + HS Diploma or GED required + Other Medical Coding Program preferred + Associate Degree Health Information Management ... RAC and non-RAC accounts, reviewing patient records for accuracy in ICD-10-CM/PCS coding , DRG assignments, and supporting clinical documentation. This includes… more
- Insight Global (Plano, TX)
- …chart reviews to accurately reflect the patient's condition. Stay current with medical coding guidelines and industry developments. Assist in developing training ... setting or a third-party vendor as a DRG Auditor or Clinical Documentation Specialist (CDS). Prior experience of working as a CDI/ Coding auditor RN background more
- Excellus BlueCross BlueShield (Rochester, NY)
- …designation within one year of hire date. + Knowledge of medical record coding conventions (eg CPT, DRG , HCPCS, ICD10, etc.). + A general understanding of ... regulatory agencies. Essential Accountabilities: Level I + Functions as a clinical reviewer of medical records, researching and investigating complex medical… more
