- Adecco US, Inc. (Chicago, IL)
- Adecco Healthcare & Life Sciences is hiring a DRG Validation RN Auditor ! This role is work from home / remote. Please see below and apply today for further ... to 5pm EST **Pay:** $40.50 to $42.76 an hour **Responsibilities of the** ** DRG Validation RN Auditor :** . Conduct MS- DRG and APR- DRG coding reviews to… more
- Hackensack Meridian Health (Hackensack, NJ)
- …this includes compliance with the Conditions of Participation for CMS. The DRG auditor is responsible for ensuring coding accuracy, coding consistency ... and serve as a leader of positive change. The **Diagnosis Related Group ( DRG ) Auditor ** is responsible for auditing clinical documentation that supports code… more
- UPMC (Pittsburgh, PA)
- UPMC Health Plan is looking for an Intermediate Clinical Auditor /Analyst to join the Quality Assurance team! This role will work standard daylight hours, Monday - ... Steel Tower, however, this role may work remotely. The Intermediate Clinical Auditor /Analyst is an integral part of the Quality Assurance and Operational Integrity… more
- Elevance Health (Denver, CO)
- **Diagnosis Related Group Clinical Validation Auditor ** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within ... one of our PulsePoint locations. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure clinical… more
- UPMC (Pittsburgh, PA)
- **UPMC Corporate Finance is hiring a full-time Compliance Auditor , Intermediate. This position will be based out of Forbes Tower in Pittsburgh, PA. This position ... 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… more
- Hackensack Meridian Health (Neptune, NJ)
- …and serve as a leader of positive change. The Coding Quality Auditor is responsible for monitoring compliance with applicable clinical documentation to support ... a Clinical Documentation Specialist includes: + Reviews Diagnosis-Related Group ( DRG ) assignment for selected Medicare/Medicaid inpatients; Hospital-Acquired Condition (HAC);… more
- Baylor Scott & White Health (Columbus, OH)
- **JOB SUMMARY** The Coding Auditor 1 is proficient in various types of coding and is responsible for performing coding quality audits and providing feedback to ... coders. The Coding Auditor 1 utilizes the International Classification of Disease (ICD-10-CM/PCS),...ensure accurate coding and grouping of classification assignment (eg, MS- DRG , APR- DRG , APC etc.) **ESSENTIAL FUNCTIONS OF… more
- Baylor Scott & White Health (Columbus, OH)
- **JOB SUMMARY** The Coding Auditor 2 is proficient in various types of coding and is responsible for performing coding quality audits, providing feedback to coders ... providing education via both written and oral presentations. The Coding Auditor 2 utilizes the International Classification of Disease (ICD-10-CM/PCS), Healthcare… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Coding Quality Auditor position is responsible for ensuring accuracy in code assignment of diagnosis and procedure to outpatient and/or ... **SERVICE ESSENTIAL FUNCTIONS** + Responds promptly to internal and external customer coding/ DRG requests. Responds promptly to Business Office requests to code or… more
- AdventHealth (Altamonte Springs, FL)
- …you'll contribute:** The inpatient or outpatient coding team Corporate Quality Auditor (QA)/Educator supports the operations of the inpatient or outpatient coding ... to achieve industry best practice levels of performance. The Corporate Quality Auditor will adhere to AdventHealth Corporate Compliance standards, as well as rules… more
- AdventHealth (Maitland, FL)
- **Coding Auditor Inpatient** **Work Hours/Shift:** + Full Time **You Will Be Responsible For:** + Performs quality reviews on coded records to validate ICD-9, ... timely clinical documentation + Assists with writing compelling appeals to all DRG denials from outside agencies referencing Official Coding Guidelines and Coding… more
- UCLA Health (Los Angeles, CA)
- Description As an Inpatient Coding Auditor with a specialization in DRG payment reviews, you will conduct thorough audits of inpatient coding to ensure ... various hospital departments. Additional responsibilities include: + Conducting quality and DRG payment reviews for inpatient services to ensure accurate coding and… more
- R1 RCM (Chicago, IL)
- …operating costs and enhancing the patient experience. As our Inpatient Production Auditor , you will be responsible for auditing inpatient cases and reviewing ... and flexible in a work environment. **RESPONSIBILITIES** + Audit inpatient cases for DRG validation + Review inpatient medical records for validation of DRG … more
- Nuvance Health (Danbury, CT)
- …(SACO) Physician Audit & Billing, the Senior Inpatient Professional Auditor providesHospital Inpatient and Outpatient coding, billing, and documentation auditing ... to ensure compliance with all Federal and State guidelines. Ensure correct DRG and APC assignments for Institutional claims. 2. Maintains confidentiality of… more
- The Davey Tree Expert Company (Tampa, FL)
- Utility Field Auditor | UAM Construction Services Tampa, FL, US, 33626 **Additional Locations:** Florida statewide **Primary Locations:** FL, Tampa, 13720 McCormick ... Dr., 33626 **Requisition ID:** 198618 **Position Overview** The Field Auditor is responsible for inspecting the physical infrastructure that provides electricity and… more
- Prime Healthcare (Ontario, CA)
- …Responsibilities The Inpatient Coder Auditor Trainee reviews and analyzes ... Specialists (CDS) or Computer Assisted Coding (CAC) software. The Inpatient Coder Auditor Trainee finalizes the coding and abstracting of the medical record upon… more
- Centers Plan for Healthy Living (Staten Island, NY)
- Claims Auditor 75 Vanderbilt Ave, Staten Island, NY 10304, USA Req #1153 Tuesday, November 5, 2024 Centers Plan for Healthy Living's goal is to create the ultimate ... for workflow enhancements. + Evaluates Prospective Payment System (PPS) (eg APC, DRG , etc.) grouping and pricing information. + Meets individual and departmental… more
- Lucile Packard Children's Hospital Stanford (Palo Alto, CA)
- …general nature, level and purpose of the job. The Senior Charge Capture Auditor works closely with clinical departments to ensure compliance with government, payer, ... third-party requirements, revenue codes assignments, CPT, HCPCS and ICD-9. + DRG and APC classification systems; medical terminology; billing and reimbursement… more
- The Arora Group (Hampton, VA)
- …last 10 years. Required experience must include Medical Severity-Diagnostic Related Group (MS- DRG ) assignment. A minimum of one year of performance in the specialty ... of Medical Auditing Specialists (NAMAS) or the Certified Evaluation and Management Auditor (CEMA). This will satisfy the Evaluation and Management (E&M) Auditor… more
- R1 RCM (Chicago, IL)
- …to appeal denied and underpaid claims. + Apply clinical judgment and knowledge for DRG downgrades performed because of a Clinical Validation Review by an insurer or ... third-party auditor . + Draft appeal letters that are well-written, logically structured, and persuasive, utilizing ICD-9/10 CM & PCS, CPT, HCPCS, NCCI guidance. +… more