- 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 (Louisville, 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