- UPMC (Pittsburgh, PA)
- UPMC Corporate Revenue Cycle is hiring a DRG Specialist to work on inpatient auditing within our Coding Department. This position will be a work-from-home ... that were performed during an episode of care. + Review and evaluate focused UPMC DRG medical records for accurate DRG assignment to ensure that all documented… more
- UPMC (Pittsburgh, PA)
- …documentation and/or clarification to accurately complete the coding process. Consult with DRG Specialist when applicable during query process. + High School ... sequenced in order of their clinical significance to accurately assign the appropriate DRG /APC/ASC or payment tier under the Prospective Payment system or DSM IV… more
- UPMC (Pittsburgh, PA)
- …documentation and/or clarification to accurately complete the coding process. Consult with DRG Specialist when applicable during query process. + High School ... in order of their clinical significance to accurately assign the appropriate DRG to guarantee accurate reimbursement on UPMC patients. + Identify incomplete… more
- Banner Health (PA)
- …quality in the Inpatient Facility Coding department. If you have experience with DRG and PCS coding/denials/audits, we want to hear from you. **Requirements:** + **5 ... acute-care Inpatient facility-based medical coding (clearly reflected in uploaded resume);** + ** DRG and PCS experience preferred;** + **Bachelors degree in HIMS or… more
- Penn Medicine (Philadelphia, PA)
- …charts that require clarification of vague or unclear documentation for accurate coding and DRG assignment to a Coding Quality Specialist to query the physician ... Are you living your life's work? HIM Inpatient Coding Specialist II Job Summary: + Performs all coding and...procedure, and secondary procedures accurately. Performs analysis of the DRG assigned to produce the highest level of reimbursement… more
- Penn Medicine (Philadelphia, PA)
- …charts that require clarification of vague or unclear documentation for accurate coding and DRG assignment to a Coding Quality Specialist to query the physician ... our future each day. Are you living your life's work? **HIM Inpatient Coding Specialist II** **Job Summary:** + Performs all coding and abstracting for Penn Medicine… more
- Penn Medicine (Philadelphia, PA)
- …charts that require clarification of vague or unclear documentation for accurate coding and DRG assignment to a Coding Quality Specialist to query the physician ... Are you living your life's work? **HIM Inpatient Coding Specialist I** Job Summary: + Performs all coding and...procedure, and secondary procedures accurately. Performs analysis of the DRG assigned to produce the highest level of reimbursement… more
- St. Luke's University Health Network (Allentown, PA)
- …regardless of a patient's ability to pay for health care. The Coding Appeals Specialist analyzes patient medical records, claims data and coding on all diagnosis and ... procedure codes to assure properly assigned MS- DRG for the purposes of appealing proposed MS- DRG and coding changes by insurance providers or their auditors.… more
- Penn Medicine (Philadelphia, PA)
- …Philadelphia, PA + Hours: 8hr Days Summary: + The Clinical Documentation Specialist will be responsible for supporting an organization-wide system for improving ... and other clinicians for complete and accurate documentation. The CD Specialist will utilize presentation, general instruction, and a compliant query discussion… more
- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The Coding Specialist codes and abstracts all pertinent patient medical information according to ICD-10-CM/PCS ... the 3M Encoder to verify and assign ICD-10-CM/PCS and CPT-4 codes, and MS- DRG /APR- DRG assignment + Maintains 95% data quality coding accuracy rate as measured… more
- Geisinger (Danville, PA)
- …of care of the patient. The role of the Clinical Documentation Improvement Specialist (CDIS) is to assist the providers with accurately identifying and documenting ... System Case Mix Index. Job Duties The RN CDI Specialist acts as a liaison between the clinical and...principal diagnosis, relevant secondary diagnoses, and procedures for accurate DRG assignment, risk of mortality, severity of illness; and… more
- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The Clinical Documentation Specialist is responsible for the review of inpatient medical records to facilitate the ... rate of 94% or greater in identifying correct concurrent initial and possible DRG when 2 or more diagnoses meet definition of PDX; reconciles correctly after… more
- Intermountain Health (Harrisburg, PA)
- …risk of mortality, and quality of care + Performs audits including DRG (Diagnosis Related Groups), ICD-10 CM/PCS (Procedure Classification System), CPT, and PSI ... of medical terminology, medical acronyms, pharmacology, anatomy and physiology and ICD-10-CM/PCS, DRG , and APR- DRG classification systems. + Ability to complete… more
- Datavant (Harrisburg, PA)
- …to realize our bold vision for healthcare. As an **Inpatient Auditing Specialist ** you will be instrumental in addressing consulting and educational needs related ... utilizing ICD-10-CM, CPT, and appropriate coding references for accurate DRG and APC assignment. + Review non-CC/MCC records to...facility or CCS HIM director. + Review disagreements on APC/ DRG changes with the appropriate manager. + Prepare the… more
- Sharecare (Harrisburg, PA)
- …with the request, authorization, company policy and HIPAA regulations. As an ROI Specialist Lead, you will continually perform at a high quality and productivity ... projects for health plan and CMS campaigns, including but not limited to: HEDIS, DRG , Risk Adjustment, Payment Integrity, RAC, CMS Audits + Receive and review audit… more
- Datavant (Harrisburg, PA)
- …and life experiences to realize our bold vision for healthcare. The Specialist is responsible for identifying, analyzing, and resolving claim denials across the ... practices, and proficiency in multiple electronic systems and software tools. The specialist serves as a key liaison between coding, billing, utilization review,… more
- Organon & Co. (Plymouth Meeting, PA)
- …professional to join our team as the MedTech Billing & Coding Contract Specialist . This role is essential in developing and implementing strategies that support ... including commercial, Medicare, and Medicaid. Serve as an expert on DRG hospital and provider reimbursement. + **Customer Engagement:** Provide customer-facing… more
- Penn Medicine (Lititz, PA)
- …analysis and provider profiling. Review coded medical records for coding and DRG accuracy by verifying that the principal diagnosis, secondary diagnoses, principal ... + Identify and communicate documentation issues and concerns that influence coding, DRG assignment, and severity of illness assessment to management as identified. +… more
- UPMC (Pittsburgh, PA)
- …the ICD-10-CM, CPT, and HCPCS codes or CPT and HCPCS ICD-10-CM-PCD and DRG assignment appropriateness to ensure consistency and efficiency in claims processing, data ... CMS and third-party payer coding, billing, and documentation compliance regulations preferred (MS- DRG , APR- DRG , APC, APG or ICD10-CM, HCPCS, CPT, Modifiers,… more
- UPMC (Pittsburgh, PA)
- …CMS, and third-party payer coding, billing, and documentation compliance regulations required (MS- DRG , APR- DRG , APC, APG or ICD10-CM, HCPCS, CPT, Modifiers, ... etc.). + Knowledge of coding/classification systems appropriate for inpatient /outpatient, DRG prospective payment system or office setting E/M codes. + Experience… more