- MetroHealth (Cleveland, OH)
- …health centers.** **Summary:** **Performs secondary clinical chart reviews, resolves DRG discrepancies, and educates clinical staff regarding opportunities for ... of additional comorbid conditions. Conducts concurrent and retrospective medical record review on defined patient populations to identify opportunities to improve… more
- University of Miami (Hialeah, FL)
- …CDIs, Coders, Quality, and other relevant multidisciplinary teams. The concurrent inpatient quality reviewer will assign a working DRG , as well as capture and ... faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Concurrent Quality… more
- SSM Health (MO)
- …the principal diagnosis, pertinent secondary diagnoses, and procedures for accurate diagnosis review group ( DRG ) assignment, risk of mortality (ROM), and ... services rendered. The CDI Specialist assesses clinical documentation through extensive review of the medical record, interaction with physicians, nursing staff,… more
- Kaleida Health (Buffalo, NY)
- …and insurance / managed care practices including but not limited to: utilization review , RAC, MAC, Q10, clinical and DRG denial management required. Reg ... - Clinical Revenue Cycle Admin **Job Description:** The Director, Clinical & DRG Denials provides clinical leadership and administrative guidance to the Clinical… more
- The Davey Tree Expert Company (Little Rock, AR)
- Traveling Field Technician 1 | DRG Southeast | UAM Field Inventory Services Little Rock, AR, US, 72201-3736 **Additional Locations:** Northeast Arkansas **Primary ... Overview** **Asset Management** is a division of **Davey Resource Group Inc. ( DRG )** which has been employee-owned since 1979. Asset Management specializes in… more
- UTMB Health (Galveston, TX)
- …for proper coding of all pertinent diagnoses and procedures and to provide optimal DRG assignment after thorough review of medical record and analysis of ... Senior DRG Coder - Revenue Cycle Coding (Certification Required)...or equivalent and three years of experience. The Sr. DRG coder must be proficient in inpatient coding with… more
- Insight Global (Miami, FL)
- Job Description Insight Global is looking to hire 2 remote Inpatient DRG Coding Specialists for a healthcare provider in the South Florida area. We are seeking a ... detail-oriented and experienced Inpatient DRG Coding Specialist to join our Health Information Management team. The ideal candidate will be responsible for… more
- CVS Health (Sacramento, CA)
- …Medical Director include support of the appeal process, clinical claim review process, pre-certification, and predetermination of covered benefits in the Commercial ... and Medicare environment. In addition, be a subject matter expert in DRG reviews and ICD-10 code selection. This Medical Director provides subject matter expertise… more
- RWJBarnabas Health (Oceanport, NJ)
- Quality Officer III (Inpatient Coding Review ) - Hybrid/RemoteReq #:0000175903 Category:Coder Status:Full-Time Shift:Day Facility:RWJBarnabas Health Corporate ... for ensuring accuracy and integrity of ICD-10-CM/PCS coding and DRG assignment for inpatient Medicare encounters. This requires critical...a team with other Quality Officers to ensure SMART review goals are met for all RWJBarnabas facilities. +… more
- R1 RCM (Detroit, MI)
- The Inpatient Coding Quality Reviewer will be responsible for reviewing inpatient coded cases for coding completeness and accuracy. This person will identify ... potential coding and DRG errors, researches appropriate guidelines to support recommended changes,...to the coder involved on a timely basis. The Reviewer provides expert coding advice to coding staff and… more
- HCA Healthcare (Nashville, TN)
- …colleagues invested over 156,000 hours volunteering in our communities. As a(an) CDI Concurrent Review and Query Specialist with Work from Home you can be a part of ... organization. We are looking for an enthusiastic CDI Concurrent Review and Query Specialist to help us reach our...+ Demonstrate knowledge of Official Coding Guidelines and the DRG Classification System to insure regulatory compliance related to… more
- Hackensack Meridian Health (Hackensack, NJ)
- …Health Information Management (HIM) education. + Minimum of 5 years progressive coding review in ICD-10-CM and DRG methodologies. + Knowledge of POA/HAC, PSI ... serve as a leader of positive change. The **Diagnosis Related Group ( DRG ) Auditor** is responsible for auditing clinical documentation that supports code assignment… more
- R1 RCM (Boise, ID)
- …completeness and accuracy. This person will identify potential coding and DRG errors, researches appropriate guidelines to support recommended changes, and ... to the coder involved on a timely basis. The Reviewer provides expert coding advice to coding staff and...+ Audits records as defined in the coding quality review plan. Review cases flagged by the… more
- St. Luke's University Health Network (Allentown, PA)
- …data and coding of all diagnosis and procedure codes to assure properly assigned MS- DRG for the purposes of appealing proposed MS- DRG and coding changes by ... retrospective medical record reviews for diagnosis and procedure code assignment and MS- DRG accuracy for inpatient encounters and CPT assignment for OP encounters.… more
- Hartford HealthCare (Newington, CT)
- …alpha numeric diagnosis/procedure codes and Medicare Severity Diagnosis Related Groups (MS- DRG ). Data is classified for internal and external statistical reporting, ... and/or encoder, coding manuals and other reference material. 3. Reviews DRG assigned to each record. Enters coded/abstracted information into software, analyzes… more
- Hackensack Meridian Health (Neptune, NJ)
- …admissions and observations as specified by the facility's Utilization Management/ Review Committee for documentation completeness and compliance with patient status. ... the medical screening process by documenting appropriateness of patient admission, working DRG & LOS information on worksheet and computer system as appropriate. +… more
- Marshfield Clinic (Park Falls, WI)
- …Uniform Hospital Discharge Data Set (UHDDS) and assignment of the appropriate MS- DRG (Medicare Severity-Diagnosis Related Group) or APR- DRG (All Patients Refined ... co-morbidities and complications, secondary conditions, surgical procedures and/or other procedures. + MS- DRG /APR- DRG + Present on admission indicators + HAC… more
- AdventHealth (Maitland, FL)
- …as indicated by the ability to complete records with a minimum of data quality review . Has responsibility to ensure the correct DRG prior to billing with the ... ability to defend the DRG assignment if questioned by an outside review agency. + Assists with DRG auditing and validation as needed for newer coders and for… more
- Molina Healthcare (NE)
- …payment integrity Clinical Operations team that has oversight for both Pre-pay and Post-pay DRG validation, Itemized Bill Review and Medical Record Review ... relevant experience, position has oversight for creation, publication, and maintenance of DRG Validation clinical policies to support Clinical review program and… more
- Stanford Health Care (Palo Alto, CA)
- …**This is a Stanford Health Care job.** **A Brief Overview** Requires review of medical record documentation to accurately assign International Classification of ... as assignment of the Medicare Severity Diagnosis Related Group (MS- DRG ) / All Patient Refined - Diagnosis Related Group...) / All Patient Refined - Diagnosis Related Group (APR- DRG ) and abstracts specific data elements for each account… more