- Mount Sinai Health System (New York, NY)
- …treatment. Resolves edits and rebills cases in 3M. Reviews and reconciles DRG discrepancies between DRGS/APR's and the Clinical Documentation Quality Improvement ... **Job Description** The purpose of DRG validation is to confirm that diagnostic, procedural...experience preferred. * Excellent current knowledge of MS-DRGs, APR-DRGs reimbursement methodology. * Good working knowledge of electronic health… more
- University of Michigan (Ann Arbor, MI)
- …possible refinement of principal diagnosis, secondary diagnoses, and/or procedures based on clinical data to facilitate appropriate DRG assignment. + Records ... Clinical Documentation Integrity Specialist III Apply Now **Job...risk of mortality (ROM) scores, as well as hospital reimbursement and the level of services provided. Collaborate with… more
- Elevance Health (Columbus, OH)
- …Inpatient Coding Credential such as CCS or CIC. + Experience with third party DRG Coding and/or Clinical Validation Audits or hospital clinical documentation ... **Diagnosis Related Group Clinical Validation Auditor** **Location:** This position will work...and reimbursed. Specializes in review of Diagnosis Related Group ( DRG ) paid claims. **How you will make an impact:**… more
- Spaulding Rehabilitation (Charlestown, MA)
- …- ( 3303241 ) **Description** **Job Summary** Under the direction of the Clinical Documentation Integrity (CDI) Manager , facilitates improvement in the overall ... mix index, estimated length of stay (where applicable) and reimbursement . Collaborates with the Interdisciplinary Care Team to be...Care Team to be successful in this role. Utilizes clinical and ICD 10 coding knowledge to obtain appropriate… more
- Abbott (Abbott Park, IL)
- …neuromodulation through modern data science and analysis **The Opportunity:** The **Program Manager for clinical training** is responsible for the development, ... retirement savings plan with high employer contribution + Tuition reimbursement , the Freedom 2 Save (https://www.abbott.com/corpnewsroom/strategy-and-strength/tackling-student-debt-for-our-employees.html) student debt program… more
- Penn Medicine (Philadelphia, PA)
- …treatment related. + Working under the leadership and moderate supervision of the Corporate Manager of Clinical Documentation and in close concert with both the ... trends in documentation and coding. + Collaborate with the Corporate Manager of Clinical Documentation Improvement to develop/upkeep efficiencies/synergies… more
- Marshfield Clinic (Marshfield, WI)
- …8:00 am - 5:00 pm (United States of America) **Job Description:** ** Clinical Documentation Specialist ( DRG focus) experience NEEDED TO APPLY** **_**Wisconsin ... Documentation Integrity (CDI) Educator/Analyst is a CDI professional with a broad clinical knowledge base and advanced understanding of DRG documentation… more
- LifePoint Health (Brentwood, TN)
- …where employees find purpose and fulfillment. *What you'll do:* As a *CDI Manager *, you willdirect the activities of the Clinical Documentation Integrity (CDI) ... *CDI Manager * *Who we are:* At Lifepoint Health, we...by assuming accountability for the ongoing success of the Clinical Documentation Integrity and DRG Downgrade Programs.… more
- Abbott (Detroit, MI)
- …high employer contribution + Tuition reimbursement , the Freedom 2 Save ... #1 Spinal cord stimulator on the market, Proclaim (TM) DRG Neurostimulator, the only FDA approved DRG ...location in Detroit currently has an opportunity for a Clinical Specialist. As a member of the clinical… more
- Guthrie (Binghamton, NY)
- …CDMP guidelines. 2. Demonstrates knowledge of CDMP guidelines and program, DRG payor issues, documentation opportunities, clinical documentation requirements, ... Summary: Responsible for improving the overall quality and completeness of clinical documentation Facilitates modifications to clinical documentation through… more
- Hartford HealthCare (Newington, CT)
- …Collaborates with clinical documentation specialists (CDS) to determine appropriate DRG assignment for compliance and reimbursement purposes. 3. Collaborates ... Leads Inpatient coding team as assigned and backs up manager in their absence. Trains and mentors new and...to assist with backlog as necessary by reviewing inpatient clinical documentation to determine the appropriate assignment of alpha… more
- Medical Mutual of Ohio (OH)
- …Ohio residents preferred. Seeking applicants with RN experience, DRG ,_** **_and/or_** **_hospital bill auditing experience._** **Responsibilities** ** Clinical ... professional claim irregularities, overpayments and provider appeals from a clinical coding perspective, applying coding guidelines. Analyzes provider billing for… more
- Hartford HealthCare (Newington, CT)
- …Collaborates with clinical documentation specialists (CDS) to determine appropriate DRG assignment for compliance and reimbursement purposes. 2. Collaborates ... other common practices across the system. *_Position Summary:_* Reviews inpatient clinical documentation to determine the appropriate assignment of alpha numeric… more
- Hartford HealthCare (Farmington, CT)
- …Collaborates with clinical documentation specialists (CDS) to determine appropriate DRG assignment for compliance and reimbursement purposes. 2. Collaborates ... other common practices across the system. *_Position Summary:_* Reviews inpatient clinical documentation to determine the appropriate assignment of alpha numeric… more
- Central Maine Medical Center (Lewiston, ME)
- …systems. Requires skill in the sequencing of diagnoses/procedures to optimize reimbursement . Requires the ability to abstract clinical information from ... and for each other every day. Position Summary: The Clinical Coder, HIM is accountable for conversion of diagnoses...or episode of care. 4. Refers chart to coding manager or director if there is a question regarding… more
- Hackensack Meridian Health (Hackensack, NJ)
- …+ Apply reason/tracking code and rationale (if needed) in 3M as needed for DRG mismatches on Clinical Documentation Improvement (CDI) reviewed cases. + Provides ... **Coding Quality Auditor** is responsible for monitoring compliance with applicable clinical documentation to support coding and billing regulations to insure… more
- Tidelands Health (Murrells Inlet, SC)
- …integrated system of inpatient records. + Knowledge of MS- DRG and APR DRG classification and reimbursement structures + Understanding of appropriate level of ... the Standards of Ethical Coding as set forth by AHIMA. Abstracting required clinical information from the medical record. Queries physicians as needed, to clarify… more
- Guthrie (Binghamton, NY)
- …for patients, based on assessed needs and available resources. The Acute Case Manager monitors clinical approaches and make recommendations for alternate levels ... outcomes. Identifies opportunities to continue or reduce costs and optimize case reimbursement . a) Identifies cost/ clinical outlier patients for intensive case… more
- BronxCare Health System (Bronx, NY)
- Overview The Case Manager will coordinate care using a collaborative approach with the multidisciplinary team in identifying the required services needed to meet an ... care and medical necessity in order to achieve certification status and insure reimbursement to the hospital. - Identify risk factors (ie actual and potential… more
- AdventHealth (Winter Garden, FL)
- …Manager ensures efficient and cost-effective care through appropriate resources monitoring, and clinical care escalations. The RN Care Manager is under the ... continuum, intervening to remove barriers to timely and efficient care delivery and reimbursement . The RN Care Manager provides education to nurses, physicians… more