- Stanford Health Care (Palo Alto, CA)
- …coding with ICD, HCPCS, CPT codes, as well as APC and DRG assignments, while identifying instances of overpayments and underpayments. Proficiency in healthcare ... claims analysis, including the ability to review , interpret, and evaluate claims data to identify trends,...successful outcomes. + Knowledge of medical and insurance terminology, MS- DRG , APR- DRG , CPT, ICD coding structures, and… more
- Zelis (FL)
- …gained, and the personal interests that shape who you are. Position Overview The Inpatient DRG Reviewer will be primarily responsible for conducting ... post-service, pre-payment and post pay comprehensive inpatient DRG reviews based on...Clinic and client specific coverage policies. Conduct prompt claim review to support internal inventory management to achieve greatest… more
- Zelis (NJ)
- …this role is responsible for conducting post-service, pre-payment and post pay comprehensive inpatient DRG Quality Assurance reviews in an effort to increase the ... savings achieved for Zelis clients. Conduct reviews on inpatient DRG claims as they compare with medical records utilizing ICD-10 Official Coding Guidelines, AHA… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …development, leadership programs and more! **Description** We are seeking an experienced ** Inpatient DRG Coding Auditor** to extract data from patient encounters ... the accuracy of DRGs. This individual will: + Reviews inpatient medical records for select payer populations post-discharge and...nursing, and other clinical staff to improve documentation. + Review ?s DRG Reassignment letters and assists… 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 ... to improve coding practices and compliance. **Essential Functions** + Performs inpatient denial reviews using ICD-10-CM/PCS and DRG validation utilizing… more
- HCA Healthcare (Miami, FL)
- …**This is a fully work from home position.** **This position requires Inpatient Coding and DRG Validation Experience.** **Schedule: Monday-Friday Day Shift** ... If you find this opportunity compelling, we encourage you to apply for our Inpatient Coding Quality Auditor opening. We promptly review all applications. Highly… more
- HCA Healthcare (Nashville, TN)
- …from home position.** **Schedule: Monday-Friday Day Shift** **This position requires DRG Validation and Inpatient Coding experience.** **Benefits** Parallon, ... We care like family! Jump-start your career as a DRG Validation Auditor today with Parallon. **This position is...encourage you to apply for our Coding Quality Audit Reviewer opening. We promptly review all applications.… more
- Datavant (Annapolis, MD)
- …allowing you to help shape the future of healthcare from your own workspace! Seeking Inpatient Auditor proficient in MS- DRG and APR- DRG **What You Will Do:** ... function and decision making + Strong organizational, teamwork, and leadership skills Seeking Inpatient Auditor proficient in MS- DRG and APR- DRG **What You… more
- TEKsystems (Rockville, MD)
- …Services, so they would like for everyone to have experience in emergency services, inpatient coding, or DRG (diagnosis-related group) coding. + This would allow ... and then they pass it off to QA for review . + They will do these cases over and...Certified Coding Specialist CCS) + Experience or exposure to inpatient coding, emergency services coding or DRG … more
- CareFirst (Baltimore, MD)
- …(all benefits/incentives are subject to eligibility requirements). **Department** Inpatient DRG Telephonic **Equal Employment Opportunity** CareFirst ... Navigator (RN) embedded at a partnering hospital will conduct concurrent review of inpatient level of care, managing the timely and smooth transition from… more
- CareFirst (Baltimore, MD)
- …(all benefits/incentives are subject to eligibility requirements). **Department** Inpatient DRG Telephonic **Equal Employment Opportunity** CareFirst ... County/Washington DC or Northern Virginia metropolitan area.** **PURPOSE:** The Inpatient Management Care Management Supervisor will direct and coordinate the… more
- Excellus BlueCross BlueShield (Rochester, NY)
- Job Description: Summary: The Payment Integrity DRG Coding & Clinical Validation Analyst position has an extensive background in acute facility-based clinical ... documentation, and/or inpatient coding and has a high level of understanding of the current MS- DRG , and APR- DRG payment systems. This position is responsible… more
- Insight Global (South Jordan, UT)
- …knowledge ( DRG & ICD-10) Registered Nurse RN (must be inpatient ) WITH coding/clinical documentation certification (2 years in clinical documentation) OR IF ... Job Description Insight Global is seeking a DRG Validation Auditor for one of our clients...extensive background in either facility-based nursing, clinical documentation, and/or inpatient coding and has a high level of understanding… more
- Elevance Health (Hanover, MD)
- …is determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** DRG CODING AUDITOR** is responsible for auditing inpatient medical ... and other documentation to evaluate issues of coding and DRG assignment accuracy. Specializes in review of...where additional recoveries may be available, such as re-admissions, Inpatient to Outpatient, and HACs. + Suggests and develops… more
- Elevance Health (Las Vegas, NV)
- …clinical documentation supports the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group ( DRG ) paid claims. **How you will ... **Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS- DRG , AP- DRG and APR- DRG )** **Virtual:** This role enables associates to work virtually… more
- UTMB Health (Galveston, TX)
- …**Minimum Qualifications** High school or equivalent and three years of experience. The Sr. DRG coder must be proficient in inpatient coding with the ability to ... coding of all pertinent diagnoses and procedures and to provide optimal DRG assignment after thorough review of medical record and analysis of DRG options.… more
- Insight Global (Plano, TX)
- …The DRG Revenue Integrity Auditor will perform Diagnostic Related Group ( DRG ) validation and quality audits on inpatient charts to ensure accurate ... Job Description Insight Global is seeking experienced DRG Auditors to join a remote healthcare organization.… more
- Houston Methodist (Houston, TX)
- …(includes CPT) (for inpatient /outpatient coding) coding classification systems + For inpatient /outpatient coding: MS- DRG , APR DRG and APC assignment ... education **WORK EXPERIENCE** + Eight years of progressive coding and/or coding review (auditing) experience at a large facility or multi-facility + Some… more
- University of Miami (Medley, FL)
- …Miami/UHealth -Health Information Management Departmenthas an exciting opportunity for a full-time Inpatient Coding Review Specialist (H) to work remotely. The ... Inpatient Coding Review Specialist (H) under...Official Coding Guidelines, UHDDS, and regulatory requirements for accurate MS- DRG assignment. + Ensures accurate capture of Severity of… more
- Veterans Affairs, Veterans Health Administration (Memphis, TN)
- …of diagnosis related groups ( DRG ),and/or assigning CPT/HCPCS codes for inpatient professional services. They independently review and abstract clinical data ... CM, PCS classification systems for inpatient facility and/or professional services. Inpatient duties consist of the performance and review of documentation… more
