- Elevance Health (Grand Prairie, TX)
- 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 (Grand Prairie, TX)
- …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 (Grand Prairie, TX)
- …Experiences** : + BA/BS preferred. + Experience with vendor based Diagnosis-Related Group ( DRG ) Coding / Clinical Validation Audit setting or hospital ... **Build the Possibilities. Make an Extraordinary Impact.** **Title** : DRG Coding Auditor (ICD-9/10CM, MS- DRG ,...+ Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines and objectivity in… more
- Deloitte (Dallas, TX)
- …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
- Molina Healthcare (Dallas, TX)
- …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