- Elevance Health (Woodbridge, NJ)
- Manager of DRG Coding ...prevent unnecessary medical-expense spending. The ** Managers of DRG Coding & Clinical Validation** ... or process improvement and efficiency recommendations. .Draws on advanced ICD-10 coding expertise, clinical guidelines, and industry knowledge to substantiate… more
- Elevance Health (Morristown, NJ)
- …Skills, Capabilities and Experiences** : + BA/BS preferred. + Experience with vendor based DRG Coding / Clinical Validation Audit setting or hospital ... ** DRG Coding Auditor Principal** **_Virtual: _**...medical audit activities. + Draws on extremely advanced ICD-10 coding expertise, clinical guidelines, and industry knowledge… more
- Elevance Health (Woodbridge, NJ)
- …Inpatient Coding Credential such as CCS or CIC. + Experience with third party DRG Coding and/or Clinical Validation Audits or hospital clinical ... **Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS- DRG , AP-...+ Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in… more
- Garnet Health (Middletown, NY)
- …Center. Responsibilities Under the direction of The Administrator, Coding & Clinical Documentation Improvement and Patient Access, the Manager of Clinical ... day to day operation of the CDI department and DRG Denials appeals process. The Manager will...and other clinical professional staff.* Knowledge of DRG and Coding appeal process Required Certification/Registration:… more
- Deloitte (Morristown, NJ)
- …A CDS: + Is knowledgeable regarding clinical documentation standards and clinical indicators which drive reimbursement, MS- DRG , APR- DRG , PSIs, HACs, ... and follow-up entries in medical records to lead to coding accuracy + Identify gaps in clinical ...CCA, CCS-P, CCS, CPC, CDIP, CCM) + Experience as clinical registered nurse, physician, physician assistant, case manager… more
- Amgen (New York, NY)
- …transform the lives of patients while transforming your career. **Key Account Manager - Cardiovascular** **Live** **What you will do** The Cardiovascular Account ... Manager will report into a Cardiovascular Account Director. Their...CV product messaging for approved CV products and delivers clinical messages compliantly within all governing policies + Accountable… more
- Molina Healthcare (Yonkers, NY)
- …regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Contributes to overarching strategy to provide quality and ... cost-effective member care. **ESSENTIAL JOB DUTIES:** + Facilitates clinical /medical reviews of retrospective medical claim reviews, medical claims and previously… more