- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** We are looking for a Revenue Integrity DRG Auditor who has a comprehensive understanding of hospital Revenue Cycle Management. ... Significant experience in the following areas: hospital inpatient coding, DRG assignment, charge capture, and hospital reimbursement methodologies. The candidate… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …leadership programs and more! **Description** We are seeking an experienced **Inpatient DRG Coding Auditor ** to extract data from patient encounters ensuring ... the accuracy and completeness of diagnosis and procedure coding, DRG assignment, and abstracted data POA, Discharge Disposition. +...+ Reviews discrepancies between the Clinical Documentation Specialist (CDS) DRG and the Coder DRG . + Reviews… more
- The Cigna Group (Bloomfield, CT)
- **The DRG Auditor performs an in-depth review of the medical record to evaluate the diagnostic and procedural information in the record and validates accurate ... coding classification for the DRG assignment for reimbursement of services rendered.** **RESPONSIBILITIES:** **Reviews clinical documentation and validates facility… 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
- Actalent (Rochester, MN)
- …Optum and Epic experience a huge plus. CCS and/or CRC are also a huge plus. DRG validation/ DRG auditor experience are also a plus. Experience Level ... Intermediate Level Pay and Benefits The pay range for this position is $35.00 - $65.00 Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to… more
- Humana (Columbus, OH)
- …caring community and help us put health first The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns ... codes (eg, ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis… more
- Elevance Health (FL)
- **Diagnosis Related Group Clinical Validation Auditor -** **Registered Nurse** **Location:** This position will work a hybrid model (remote and office). Ideal ... one of our PulsePoint locations. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure clinical… more
- Houston Methodist (Miami, FL)
- **Coding Quality Auditor - 100% Remote (Must Live in FL, TN, GA, LA, WA State, or TX)** At Houston Methodist, the Coding Quality Auditor position is responsible ... **SERVICE ESSENTIAL FUNCTIONS** + Responds promptly to internal and external customer coding/ DRG requests. Responds promptly to Business Office requests to code or… 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
- 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.) **WORK MODEL/SALARY** 100%… 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
- R1 RCM (Detroit, MI)
- …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
- AdventHealth (Maitland, FL)
- **Coding Auditor Inpatient** **- Virtual** **Work Hours/Shift:** + Full Time Virtual **You Will Be Responsible For:** + Performs quality reviews on coded records to ... timely clinical documentation + Assists with writing compelling appeals to all DRG denials from outside agencies referencing Official Coding Guidelines and Coding… 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
- Prime Healthcare (Ontario, CA)
- …Responsibilities The Inpatient Coder Auditor Trainee reviews and analyzes ... Specialists (CDS) or Computer Assisted Coding (CAC) software. The Inpatient Coder Auditor Trainee finalizes the coding and abstracting of the medical record upon… more
- Houston Methodist (Houston, TX)
- **Coding Quality Auditor - 100% Remote (Must Live in FL, TN, GA, LA, WA State, or TX)** At Houston Methodist, the Coding Apprentice position is responsible for ... application of positive language principles + Knowledge of coding classification systems, DRG and APC systems, official coding guidelines and coding compliance +… more
- Centers Plan for Healthy Living (Staten Island, NY)
- Claims Auditor 75 Vanderbilt Ave, Staten Island, NY 10304, USA Req #1153 Monday, December 2, 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
- 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
- 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