- 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
- R1 RCM (Boise, ID)
- As the Inpatient Coding and Documentation Auditor I, your primary role will be auditing inpatient cases for DRG validation and/or documentation improvement. ... accounts. Opportunity for growth includes a client facing Lead Auditor role and an internally facing Mentor role. Everyday...RHIA, RHIT, and/or CCS + 3+ years of ICD-10 coding and DRG reimbursement experience, with recent… more
- R1 RCM (Detroit, MI)
- …one that promotes patient satisfaction and improves financial performance. As the Inpatient Coding and Documentation Auditor II, your primary role will be ... auditing inpatient cases for DRG validation and/or documentation improvement. This consists of reviewing...accounts. Opportunity for growth includes a client facing Lead Auditor role and an internally facing Mentor role. Every… more
- TEKsystems (Dallas, TX)
- Description: Coding Auditor - * Coding ...the physician order to book the surgery. * Pre-service DRG review - review inpatient cases prior to date ... there are errors and site resources that support code choices. * Pre-service scheduling coding review - review medical records prior to date of service to determine… more
- Hackensack Meridian Health (Hackensack, NJ)
- …to transform healthcare and serve as a leader of positive change. The ** Coding Quality Auditor ** is responsible for monitoring compliance with applicable ... weekend.** **Responsibilities** A day in the life of an ** Coding Quality Auditor ** at **Hackensack Meridian** **_Health_**...diagnosis and procedure codes and charts abstracted information for DRG assignments into the 3M coding computer… more
- Houston Methodist (Fort Worth, 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 (Tampa, FL)
- …as a Primary Stroke Center. **The role you'll contribute:** The Inpatient Coding Quality Auditor , under general supervision of the Inpatient Operations ... responsible for the daily auditing of records. The Inpatient Coding Quality Auditor works in collaboration with...you'll bring to the team:** . Reviews records for DRG and overall coding accuracy retrospectively and… 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
- The Mount Sinai Health System (New York, NY)
- …or equivalent experience preferred. 10 years experience, to include 3+ years of medical/surgical coding and 3+ years of DRG appeal. Must have excellent working ... the All-Payer DRG reimbursement methodology. Demonstrated knowledge of ICD-9 codes, DRG and CPT coding . **REQUIRED SKILLS** Certified Coding Specialist… more
- Northwell Health (Garden City, 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. ... - BSN or MSN candidates with a HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist-Clinical.** Validates Acute Inpatient coded… more
- Elevance Health (Denver, CO)
- … 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 ** **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
- Medical Mutual of Ohio (OH)
- …,_** **_and/or_** **_hospital bill auditing experience._** **Responsibilities** **Clinical Auditor ** + **Audits outpatient, inpatient and professional claims from ... professional claim irregularities, overpayments and provider appeals from a clinical coding perspective, applying coding guidelines. Analyzes provider billing… more
- Veterans Affairs, Veterans Health Administration (Biloxi, MS)
- …Management section at the Gulf Coast Veterans Health Care System. MRT (Coder) Auditor are skilled in classifying medical data from patient health records in the ... offices, group practices, multi-specialty clinics, and specialty centers. These coding practitioners analyze and abstract patients' health records and assign… more
- Prime Healthcare (Ontario, CA)
- …assigned by the Coders or Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software. The Inpatient Coder Auditor Trainee finalizes the ... the clinical documentation of the respective medial record. Holding a senior coding position, assumes primary responsibility for DRG validation/accuracy, primary… 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
- Texas Health Resources (Arlington, TX)
- …in APC and DRG methodologies and all regulatory/payer requirements associated with coding . Demonstrated knowledge of an ability to apply THR coding policies ... **Education & Quality IP Coding Analyst** _Are you looking for a rewarding...**REQUIRED** Other CIC (Certified Inpatient Coder), CMA (Certified Medical Auditor ) upon hire **REQUIRED** **Skills** Proficient in software applications… 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 (Chicago, IL)
- …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
- 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
- University of Rochester (Rochester, NY)
- …with project management preferred. + Prior experience with APG, APC, and/or DRG coding methodologies preferred. + Prior experience with professional billing ... issues and Medicare and Medicaid requirements. Acts as a resource on billing, coding and complex reimbursement issues to Medical Center personnel on a daily basis.… more