- Kaleida Health (Buffalo, NY)
- ** Director Clinical and DRG Denials ** **Location:** Larkin Bldg @ Exchange Street Location of Job: US:NY:Buffalo Work Type: Full-Time **Shift:** Shift 1 ... Job Description **Summary:** The Director , Clinical & DRG Denials provides clinical leadership and administrative guidance to the Clinical … more
- Community Health Systems (Franklin, TN)
- **Job Summary** The DRG Denials Auditor conducts hospital inpatient DRG denial audits for both RAC and non-RAC accounts, reviewing patient records for ... accuracy in ICD-10-CM/PCS coding, DRG assignments, and supporting clinical documentation. This...denial and appeal status. + Consults with Coordinator and/or Director , Coding Denials and Appeals during any… more
- Datavant (Nashville, TN)
- …should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and appeal writing for inpatient admission. Experience with ... clinical criteria resources and payor guidelines. **You will:** +...Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and appeal writing for… more
- Rochester Regional Health (Rochester, NY)
- Job Title: Director , CDI Department: Clinical Documentation ImprovementLocation: Riedman CampusHours Per Week: 40Schedule: Monday - Friday, 8am - 4:30pmSUMMARY ... The Clinical Documentation Improvement Director provides a key...system committees and work groups, including billing, revenue cycle, denials , and others as assigned. + Ensure effective staffing… more
- St. Luke's University Health Network (Allentown, PA)
- …reviews for clinical validation of diagnosis and procedure code assignment and MS- DRG /APR- DRG accuracy based on denials or audit findings from government ... patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records,...all diagnosis and procedure codes to assure properly assigned MS- DRG or APR- DRG for the purpose of… more
- Trinity Health (Livonia, MI)
- …and Local Health Physician Champions, Chief Medical Officers, HM Executive Leadership, clinical staff, coding and denials teams to facilitate documentation ... and day-to-day management of the CDI programs. Works with Director , CDI to ensure the program is in alignment...supports the patient's severity of illness, risk of mortality, clinical validity and proper DRG assignment. **ESSENTIAL… more
- Covenant Health Inc. (Knoxville, TN)
- …Working directly with the physicians, Manager of Corporate Coding Services, Director of Registration/Admitting, and medical staff education efforts, serves as the ... user advocate between Health Information Management (HIM), Clinical Effectiveness, and Registration. Other job duties include: improving health record documentation… more
- AdventHealth (Tampa, FL)
- …Research Institute, also located at AdventHealth Tampa, leads the way in clinical and academic research in the areas of neuroscience, cardiovascular medicine, ... and other diseases. **The ro** **le you'll contribute:** Oversees site-based Clinical Documentation Integrity (CDI) program; monitors and maintains the timeliness of… more
- McLaren Health Care (Grand Blanc, MI)
- …opportunities for potential denials management impact on medical necessity and DRG denials 4. Conducts patient medical record reviews and utilizes ... **Position Summary** : Responsible for assisting the Corporate Director of Denials Management in the coordination of day-to-day operations and workflow of the … more
- HonorHealth (AZ)
- …Works with Director , Management and staff to facilitate client profiles, clinical service utilization and profitable revenue management. + Serves as a consultant ... care services, a cancer care network, outpatient surgery centers, clinical research, medical education, a foundation, an accountable care...severity, acuity and risk of mortality, in addition to DRG assignment. The PA will act as a liaison… more
- BronxCare Health System (Bronx, NY)
- …with the Department Denial and Appeals Coordinators, Physician Advisors, and the clinical staff, the Appeal Manager is responsible to develop a strong appeal ... the staff on identified deficiencies to best respond to all hospital denials notification and documentation efforts. The Appeals Manager will provide timely tracking… more
- AdventHealth (Orlando, FL)
- …and regulatory agencies. It also serves as subject matter expert, providing clinical expertise and business direction in support of medical management programs, ... the other medical directors. Advise and educate Utilization Management staff regarding clinical issues. Acts as liaison for and with attending physicians to arrive… more
- Sharp HealthCare (San Diego, CA)
- … DRG coding and CPT coding classification. + Certified Clinical Documentation Specialist (CCDS) - Various-Employee provides certificate -PREFERRED + Certified ... Day **FTE** 1 **Shift Start Time** **Shift End Time** Certified Clinical Documentation Specialist (CCDS) - Various-Employee provides certificate; Other; Certified… more
- Ventura County (Ventura, CA)
- …the Health Information Management (HIM) department related to coding and CDI ( clinical documentation improvement). The ideal candidate will have a Bachelor's Degree ... rate, compliance rate with quality standards and HCAI requirements; + Reviews insurance denials and submit appeals as necessary, provide education to coders based on… more
- Novant Health (Charlotte, NC)
- …and oversight of all aspects of Health Information Management (HIM), coding, clinical documentation, and revenue integrity across the enterprise. This role involves ... overseeing strategic planning, leadership, and operations support for clinical work such as utilization review, coding, clinical documentation improvement,… more
- AdventHealth (Hinsdale, IL)
- …ensures efficient and cost-effective care through appropriate resources monitoring and clinical care escalations. The Social Worker is under the general supervision ... and communicates these goals and preferences to the multidisciplinary team. Incorporate clinical , social and financial factors into the transition of care plan.… more
- AdventHealth (Overland Park, KS)
- …ensures efficient and cost-effective care through appropriate resources monitoring and clinical care escalations. The Social Worker is under the general supervision ... and communicates these goals and preferences to the multidisciplinary team. + Incorporate clinical , social and financial factors into the transition of care plan. +… more
- AdventHealth (Winter Park, FL)
- …and Degrees without out-of-pocket tuition expense) *For eligible positions* + Nursing Clinical Ladder Program *For eligible positions* + Whole Person Well-being and ... Manager ensures efficient and cost-effective care through appropriate resources monitoring, and clinical care escalations. The RN Care Manager is under the general… more
- AdventHealth (Minneola, FL)
- …Degrees without out-of-pocket tuition expense) *For eligible positions* + Nursing Clinical Ladder Program*For eligible positions* + Whole Person Well-being and ... Manager ensures efficient and cost-effective care through appropriate resources monitoring, and clinical care escalations. The RN Care Manager is under the general… more
- Texas Health Resources (Arlington, TX)
- …organization remains compliant and proactive. Strategic Planning Assistance - Support the Director in developing the annual work plan to strengthen compliance and ... additional reviews to assist departments handling Medicare, OIG, or non-Medicare denials . Provide expert analysis on coding, documentation, and applicable regulatory… more