- Elevance Health (Louisville, KY)
- ** Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This role enables associates to work virtually ... for employment, unless an accommodation is granted as required by law. The ** Diagnosis Related Group Clinical Validation Auditor** is responsible for… more
- Molina Healthcare (Lexington, KY)
- …Job Summary The RN Lead, DRG Coding/Validation provides lead level support developing diagnosis - related group (DRG) validation tools and process improvements ... Monday- Friday 8:00am - 5:00pm Remote position Essential Job Duties * Develops diagnosis - related group (DRG) validation tools to build workflow processes… more
- Molina Healthcare (Lexington, KY)
- …reports quality of care issues. + Assists with complex claim review including diagnosis - related group (DRG) validation, itemized bill review, appropriate ... regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Contributes to overarching strategy to provide quality and… more
- CenterWell (Frankfort, KY)
- …Coding Operations conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid ... judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, uses independent judgment requiring… more