• DRG Validation RN Auditor

    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 ... - Friday, 8am 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… more
    Adecco US, Inc. (11/05/24)
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  • Intermediate Clinical Auditor

    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 ... Tower, however, this role may work remotely. The Intermediate Clinical Auditor /Analyst is an integral part of...regulatory requirements, and resource utilization. This includes using vast clinical knowledge to ensure correct DRG procedural… more
    UPMC (11/01/24)
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  • Diagnosis Related Group Clinical Validation…

    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 ... one of our PulsePoint locations. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing...as CCS or CIC. + Experience with third party DRG Coding and/or Clinical Validation Audits or… more
    Elevance Health (11/08/24)
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  • Coding Quality Auditor , Clinical

    Hackensack Meridian Health (Neptune, NJ)
    …Quality Auditor is responsible for monitoring compliance with applicable clinical documentation to support coding and billing regulations to ensure appropriate ... Clinical Documentation Specialist includes: + Reviews Diagnosis-Related Group ( DRG ) assignment for selected Medicare/Medicaid inpatients; Hospital-Acquired Condition (HAC);… more
    Hackensack Meridian Health (11/02/24)
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  • Diagnosis Related Group Auditor

    Hackensack Meridian Health (Hackensack, NJ)
    …a leader of positive change. The **Diagnosis Related Group ( DRG ) Auditor ** is responsible for auditing clinical documentation that supports code assignment ... this includes compliance with the Conditions of Participation for CMS. The DRG auditor is responsible for ensuring coding accuracy, coding consistency… more
    Hackensack Meridian Health (09/06/24)
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  • Coding Auditor I - Education Program

    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 (11/08/24)
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  • Coding Auditor II - Education Program

    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
    Baylor Scott & White Health (11/08/24)
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  • Coding Quality Auditor - 100% Remote

    Houston Methodist (Houston, TX)
    …appropriate, utilizing the established physician query process. Provides assistance to Clinical Documentation Management Program (CDMP) with appropriate MS- DRG ... At Houston Methodist, the Coding Quality Auditor position is responsible for ensuring accuracy in...FUNCTIONS** + Responds promptly to internal and external customer coding/ DRG requests. Responds promptly to Business Office requests to… more
    Houston Methodist (09/14/24)
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  • A**Divisional Coding Quality Auditor

    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 (10/24/24)
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  • Inpatient Coding Auditor

    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, ... and overall accuracy of coding + Reviews, analyzes, and interprets clinical documentation, seeking clarification from the physician when discrepancies exist.… more
    AdventHealth (11/07/24)
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  • Coder Auditor Trainee

    Prime Healthcare (Ontario, CA)
    …Responsibilities The Inpatient Coder Auditor Trainee reviews and analyzes ... accuracy of diagnosis and procedure codes assigned by the Coders or Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software. The… more
    Prime Healthcare (10/19/24)
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  • Senior Charge Capture Auditor - TxCtr-Admin…

    Lucile Packard Children's Hospital Stanford (Palo Alto, CA)
    …the 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 internal charge capture policies; provides education to the clinical departments. This position works with Med Assets software to manage clinical more
    Lucile Packard Children's Hospital Stanford (08/27/24)
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  • RN- Clinical Documentation Specialist,…

    SSM Health (MO)
    …Summary:** Performs as a vital member of the interdisciplinary care team member, an auditor , and an educator ensuring medical records are complete and clinical ... and electronic health record charts that accurately capture the clinical picture. **Job Responsibilities and Requirements:** PRIMARY RESPONSIBILITIES + Reviews… more
    SSM Health (10/10/24)
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  • Clinical Coding Appeals Nurse

    R1 RCM (Chicago, IL)
    …+ Review and interpret medical records 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… more
    R1 RCM (11/06/24)
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  • Medical Coder-Inpatient

    The Arora Group (Hampton, VA)
    …+ Have advanced knowledge of the International Classification of Diseases, Clinical Modification (ICD-CM); Healthcare Common Procedure Coding System (HCPCS); and ... 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… more
    The Arora Group (11/08/24)
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  • REMOTE Inpatient Coder

    TEKsystems (Baltimore, MD)
    …(dictionaries, Coding Clinics, CPT assistant, Coding Policies, other literature, Clinical Documentation Specialists, Coordinator, Internal Auditor , etc) to ... and in a timely manner. + Assigns the appropriate APR/ DRG . + Is familiar with and follows the Coding...documents. Notifies admitting of registration errors. + Works with Clinical Documentation Specialists to develop a good working team.… more
    TEKsystems (10/30/24)
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  • Assistant Director, Corporate Compliance

    Brockton Hospital (Brockton, MA)
    …program requirements. Clearly communicate such requirements to management, clinical and operations staff. Conducts and coordinates compliance investigations ... issues. + Supports internal and external audits of HCPCS, CPT coding, DRG coding, and medical record reviews, using proven healthcare audit methodology, with… more
    Brockton Hospital (10/19/24)
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  • Customer Service Representative (Remote)

    Kepro (Seven Hills, OH)
    …Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver ... payment for received services + Identify medical claims meeting CPT/ DRG audit criteria and submit billing data and healthcare...submit billing data and healthcare records to the third-party auditor + Serve as a liaison between internal teams… more
    Kepro (10/11/24)
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  • Compliance Analyst/Educator, URMC

    University of Rochester (Rochester, NY)
    GENERAL PURPOSE: Oversees and supports a portfolio of clinical specialties as assigned by Director of Compliance through review, analysis, communication and training ... with project management preferred. + Prior experience with APG, APC, and/or DRG coding methodologies preferred. + Prior experience with professional billing in… more
    University of Rochester (10/29/24)
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