- TEKsystems (Virginia Beach, VA)
- DRG Auditor (CCS) Location: Fully remote - Must be in approved state Experience Level: Expert Employment Type: 6 month contract to hire (permanent) Salary: ... and pre-bill; audits the accuracy and completeness of diagnosis and procedure coding, DRG assignment, and abstracted data Benefits of this Role: + Weekly paychecks +… more
- TEKsystems (Atlanta, GA)
- …and pre-bill; audits the accuracy and completeness of diagnosis and procedure coding, DRG assignment, and abstracted data Skills: Inpatient Coding, CCS, DRG , ... Epic, 3M Additional Skills & Qualifications: Academic hospital experience High acuity experience Trauma experience Rehab and LTAC experience Inpatient audit experience Experience Level: Entry Level About TEKsystems: We're partners in transformation. We help… 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 (Morristown, NJ)
- **Diagnosis Related Group Clinical Validation Auditor -RN** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live ... one of our PulsePoint locations. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure clinical… more
- Highmark Health (Columbus, OH)
- …II code and modifier assignments, ICD diagnosis and procedure coding, DRG /APC structure according to regulatory requirements. Reports findings both verbally and ... systems, missed secondary diagnoses and procedures and ensures compliance with DRG /APC structure and regulatory requirements. Performs periodic claim form reviews to… 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
- R1 RCM (Boise, ID)
- …reducing operating costs and enhancing the patient experience. The Coding Denial Auditor will be responsible for reviewing denial coded cases for coding completeness ... and accuracy. This person will identify potential coding and DRG errors, researches appropriate guidelines to support recommended changes, and communicates the… 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 Remote **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
- R1 RCM (Detroit, MI)
- …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
- 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
- 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
- Northwell Health (Port Jefferson, NY)
- …Record. Job Responsibility 1.Leverages clinical expertise to identify and validate DRG code assignment. 2.Full review of CDI suggested code changes 3.Demonstrates ... codes on Medicare/non-Medicare charts for compliance to rules and conventions. 7.Communicates DRG changes and rationale to the coding and CDI staff. 8.Identifies… more
- Scottish Rite for Children (Dallas, TX)
- …as it relates to documentation of diagnoses and procedures for accurate assignment of DRG /APR- DRG , that have an impact on severity of illness (SOI) levels. + ... fellows, residents, allied health staff and working closely with Internal Coding Auditor and HIM coding staff + Collaborates with appropriate Empower Analysts to… 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 (Boise, ID)
- …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