- 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
- 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
- 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
- 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 (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
- 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)
- …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
- 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, ... and overall accuracy of coding + Reviews, analyzes, and interprets clinical documentation, seeking clarification from the physician when discrepancies exist.… more
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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