- University Medical Center of El Paso (El Paso, TX)
- Job Summary: The Second Level Reviewer Registered Nurse plays a pivotal role in conducting critical, high-risk and intricate secondary case reviews that are ... to maintain effective interpersonal relationships. Ability to understand and follow instructions. Proficiency with ICD-10-CM/PCS, APR DRG , and MS DRG required. more
- GHR Healthcare (Atlanta, GA)
- …Summary: The Medical Coder accurately assigns ICD-10-CM, CPT codes, APC's, and DRG 's for all relevant acute care and hospital patient encounters. They actively ... complete physician queries following AHIMA physician query standards. Quality Assurance: Review all CDI concurrent reviews before releasing inpatient accounts for… more
- Careers Integrated Resources Inc (Costa Mesa, CA)
- …the use of the contract management tool for proper pricing (Examples: APC, DRG , APRDRG). . Reviews and initiates the initial appeal for underpayments observing all ... . Reports new/unknown billing edits to direct supervisor for review and resolution. . Has a strong understanding of...full at the me payment is due. . May review for applicable cash rates, special rates, applicable professional… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …patient needs; Works collaborate with the Physicians, patient/family, nursing, utilization review and other members of the healthcare team to assure patient ... while managing patient's length of stay based on working DRG /admitting diagnosis. Communicates with Physician, patient/family, and other disciplines the… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …operated by NGHS. Collaborates with the physicians, patients, families, nursing, utilization review and other members of the health care team to ensure patient ... while managing the patient's length of stay based on working DRG /admitting diagnosis. Communicates with the physician, patient, family and other disciplines… more
- Zelis (TX)
- Position Overview: The Inpatient DRG Reviewer will be primarily responsible for conducting post-service, pre-payment and post pay comprehensive inpatient DRG ... based clinical criteria plan, and policy exclusions. Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10 Official Coding Guidelines,… more
- University of Miami (Hialeah, FL)
- …CDIs, Coders, Quality, and other relevant multidisciplinary teams. The concurrent inpatient quality reviewer will assign a working DRG , as well as capture and ... faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Concurrent Quality… more
- SSM Health (MO)
- …the principal diagnosis, pertinent secondary diagnoses, and procedures for accurate diagnosis review group ( DRG ) assignment, risk of mortality (ROM), and ... services rendered. The CDI Specialist assesses clinical documentation through extensive review of the medical record, interaction with physicians, nursing staff,… more
- Geisinger (Danville, PA)
- Job Summary A clinical concurrent reviewer applies clinical and coding knowledge to concurrently evaluate the clinical indicators, diagnoses, and treatment plan for ... identifies potential gaps in physician documentation and CDI capture. The CDI second level reviewer (CDI SLR) is an advanced concurrent reviewer who uses his/her… more
- Zelis (Morristown, NJ)
- Position Overview: The Nurse Reviewer is primarily responsible for conducting post-service, pre or post payment in-depth claim reviews based on accepted medical ... billing and coding rules, plan policy exclusions, and payment errors/overpayments. Conduct review of facility and outpatient bills as it compares with medical… more
- The Mount Sinai Health System (New York, NY)
- **JOB DESCRIPTION** The DRG Appeals Analyst - CDI Liaison is responsible for analyzing medical records, claims data, and coding on all diagnoses and procedures (both ... and surgical) to assure properly assigned diagnostic related grouping ( DRG ) for purposes of appeal. This individual assures that...assigned by the client was properly assigned based upon review of the medical documentation and application of the… more
- Elevance Health (Indianapolis, IN)
- …clinical reviews of medical records and other documentation to evaluate issues of coding and DRG assignment accuracy. Specializes in review of DRG coding via ... ** DRG (DIAGNOSTIC RELATED GROUP) CODING AUDITOR** **Location** :...statement sent in by acute care hospitals on submitted DRG . **How you will make an impact:** + Analyzes… more
- Kaleida Health (Buffalo, NY)
- …and insurance / managed care practices including but not limited to: utilization review , RAC, MAC, Q10, clinical and DRG denial management required. Reg ... - Clinical Revenue Cycle Admin **Job Description:** The Director, Clinical & DRG Denials provides clinical leadership and administrative guidance to the Clinical… more
- The Davey Tree Expert Company (Little Rock, AR)
- Traveling Field Technician 1 | DRG Southeast | UAM Field Inventory Services Little Rock, AR, US, 72201-3736 **Additional Locations:** Northeast Arkansas **Primary ... Overview** **Asset Management** is a division of **Davey Resource Group Inc. ( DRG )** which has been employee-owned since 1979. Asset Management specializes in… more
- The Davey Tree Expert Company (Atlanta, GA)
- Traveling Inventory Specialist | DRG Southeast | UAM Field Inventory Services Atlanta, GA, US, 30360 **Additional Locations:** Carrolton, GA and Surrounding Areas ... Overview** Asset Management is a division of Davey Resource Group Inc. ( DRG ) which has been employee-owned since 1979. Asset Management specializes in managing… more
- R1 RCM (Detroit, MI)
- …and an internally facing Mentor role. Every day in this role you will: . Review inpatient medical records for validation of DRG assignment . Provide detailed ... Auditor II, your primary role will be auditing inpatient cases for DRG validation and/or documentation improvement. This consists of reviewing accounts in… more
- R1 RCM (Boise, ID)
- …role and an internally facing Mentor role. Everyday in this role you will: + Review inpatient medical records for validation of DRG assignment + Provide detailed ... Auditor I, your primary role will be auditing inpatient cases for DRG validation and/or documentation improvement. This consists of reviewing accounts in proprietary… more
- The Davey Tree Expert Company (Rochester, NY)
- Design Field Technician 1 | DRG Northeast | UAM Make Ready Engineering Rochester, NY, US, 14611 **Additional Locations:** New York Statewide **Primary Locations:** ... **Learn to identify electrical/communication utility equipment and potential hazards.** + ** Review and/or correct data integrity errors within GIS databases.** +… more
- Virginia Mason Franciscan Health (Bremerton, WA)
- …more! **Responsibilities** Job Summary: This role is responsible for the review of medical records for appropriate admission status and continued hospitalization. ... in collaboration with the attending physician, consultants, second level physician reviewer and the Care Coordination staff utilizing evidence-based guidelines and… more
- Hackensack Meridian Health (Hackensack, NJ)
- …Health Information Management (HIM) education. + Minimum of 5 years progressive coding review in ICD-10-CM and DRG methodologies. + Knowledge of POA/HAC, PSI ... serve as a leader of positive change. The **Diagnosis Related Group ( DRG ) Auditor** is responsible for auditing clinical documentation that supports code assignment… more
