- R1 RCM (Boise, ID)
- … Auditor I, your primary role will be auditing inpatient cases for DRG validation and/or documentation improvement. This consists of reviewing accounts in ... role you will: + Review inpatient medical records for validation of DRG assignment + Provide detailed...RHIA, RHIT, and/or CCS + 3+ years of ICD-10 coding and DRG reimbursement experience, with recent… more
- R1 RCM (Detroit, MI)
- … Auditor II, your primary role will be auditing inpatient cases for DRG validation and/or documentation improvement. This consists of reviewing accounts in ... accounts. Opportunity for growth includes a client facing Lead Auditor role and an internally facing Mentor role. Every...role you will: . Review inpatient medical records for validation of DRG assignment . Provide detailed… more
- Elevance Health (Columbus, OH)
- … 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...and reimbursed. Specializes in review of Diagnosis Related Group ( DRG ) paid claims. **How you will make an impact:**… more
- Northwell Health (Garden City, NY)
- …standards are maintained in compliance with Federal and State regulations. 5.Applies coding rules and regulations to the validation review process. 6.Reviews ... Medicare/non-Medicare charts for compliance to rules and conventions. 7.Communicates DRG changes and rationale to the coding ...7.Communicates DRG changes and rationale to the coding and CDI staff. 8.Identifies appropriate coding … more
- R1 RCM (Chicago, IL)
- …judgment and knowledge for DRG downgrades performed because of a Clinical Validation Review by an insurer or third-party auditor . + Draft appeal letters ... AI, intelligent automation, and workflow orchestration. As our **Clinical Coding Appeals Nurse** , you will help review and...day you will review medical records to ensure appropriate coding of removed or revised diagnosis and procedure codes.… more