- Hackensack Meridian Health (Hackensack, NJ)
- …includes compliance with the Conditions of Participation for CMS. The DRG auditor is responsible for ensuring coding accuracy, coding consistency and ... and serve as a leader of positive change. The **Diagnosis Related Group ( DRG ) Auditor ** is responsible for auditing clinical documentation that supports code… more
- TEKsystems (Virginia Beach, VA)
- DRG Auditor (CCS) Location: Fully remote...stable and reputable company Qualifications: . 3+ years of DRG coding /inpatient coding experience Active ... and pre-bill; audits the accuracy and completeness of diagnosis and procedure coding , DRG assignment, and abstracted data Benefits of this Role: + Weekly… 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… more
- Highmark Health (Columbus, OH)
- …HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding , DRG /APC structure according to regulatory requirements. Reports findings both ... Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or physician...In-depth knowledge of ICD CM, ICD PCS and CPT/HCPCS coding systems. Must be proficient in DRG /APC… more
- R1 RCM (Boise, ID)
- …cash flows while 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… 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… more
- AdventHealth (Altamonte Springs, FL)
- …**Monday-Friday** **Remote** **The role you'll contribute:** The inpatient or outpatient coding team Corporate Quality Auditor (QA)/Educator supports the ... . Expert level knowledge of Medicare Severity Diagnosis-Related Groups (MS- DRG ), and All Patient Refined Diagnosis-Related Groups (APR ...REQUIRED:** . Five (5) years of inpatient or outpatient coding or Coding Quality Auditor … 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 ... + RHIA, RHIT, or CCS certification or credential **Job Summary:** The Inpatient Coding Auditor , under general supervision, is responsible for validating the … more
- Nuvance Health (Danbury, CT)
- …Officer (SACO) Physician Audit & Billing, the Senior Inpatient Professional Auditor providesHospital Inpatient and Outpatient coding , billing, and documentation ... advanced expertise in regards to medical terminology, anatomy, physiology, documentation, coding guidelines, state and federal regulations. Works closely with all… 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 ... for the validation process while evaluating claim reimbursement potential based on coding assignment. To thrive you must be detail-oriented and flexible in a… more
- Northwell Health (Port Jefferson, NY)
- …6.Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions. 7.Communicates DRG changes and rationale to the coding and CDI staff. ... Record. Job Responsibility 1.Leverages clinical expertise to identify and validate DRG code assignment. 2.Full review of CDI suggested code changes 3.Demonstrates… 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)
- … Credential such as CCS or CIC. + Experience with third party DRG Coding and/or Clinical Validation Audits or hospital clinical documentation improvement ... **Diagnosis Related Group Clinical Validation Auditor -RN** **Location:** This position will work a hybrid...and reimbursed. Specializes in review of Diagnosis Related Group ( DRG ) paid claims. **How you will make an impact:**… more
- UPMC (Pittsburgh, PA)
- …auditing and compliance. + Extensive knowledge of CMS, and third-party payer coding , billing, and documentation compliance regulations required (MS- DRG , APR- ... APC, APG or ICD10-CM, HCPCS, CPT, Modifiers, etc.). + Knowledge of coding /classification systems appropriate for inpatient /outpatient, DRG prospective payment… 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, ... and taking corrective action. Specific role duties + Accurate charge capture, primary coding changes liaison + Build and charge appropriately in epic for all… more
- MD Anderson Cancer Center (Houston, TX)
- …of institutional coding policies and procedures; maintains knowledge of ICD-10-CM, PCS, DRG , SOI, ROM and CPT-4 coding guidelines according to CMS, AMA, AHA ... and the public. **S** **ummary** The primary purpose of the Coordinator, Coding Training position is: Facilitate training and auditing services for specific … more
- R1 RCM (Boise, ID)
- …analytics, AI, intelligent automation, and workflow orchestration. As our **Clinical Coding Appeals Nurse** , you will help review and interpret medical ... day you will review medical records to ensure appropriate coding of removed or revised diagnosis and procedure codes....underpaid claims. + Apply clinical judgment and knowledge for DRG downgrades performed because of a Clinical Validation Review… more
- Scottish Rite for Children (Dallas, TX)
- …education with physicians, fellows, residents, allied health staff and working closely with Internal Coding Auditor and HIM coding staff + Collaborates with ... and documentation improvement opportunities for provider education. + Identifies and escalates coding issues and in recommending coding workflow solutions to… more
- The Arora Group (Hampton, VA)
- …full-time position is Monday-Friday, 8 hours shifts between 7:30am and 4:30pm. TELEWORK CODING IS NOT AN OPTION. DUTIES OF THE MEDICAL CODER-INPATIENT: + Have ... Classification of Diseases, Clinical Modification (ICD-CM); Healthcare Common Procedure Coding System (HCPCS); and Current Procedural Terminology (CPT). + The… more
- Brockton Hospital (Brockton, MA)
- …requirements and identified issues. + Supports internal and external audits of HCPCS, CPT coding , DRG coding , and medical record reviews, using proven ... government payers, including Medicare and Medicaid. Collaborate with SHC's Healthcare's Compliance Auditor to meet audit plan objectives. + Works with SHC management… more