- Elevance Health (Chicago, IL)
- ** DRG Coding Auditor (DIAGNOSTIC RELATED...: + BA/BS preferred. + Experience with vendor based DRG Coding / Clinical Validation Audit ... is determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** DRG Coding Auditor ** is responsible for auditing inpatient… more
- Elevance Health (Morristown, NJ)
- … 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 -RN** **Location:** This position will...and reimbursed. Specializes in review of Diagnosis Related Group ( DRG ) paid claims. **How you will make an impact:**… more
- AdventHealth (Maitland, FL)
- ** Coding Auditor Inpatient** **Work Hours/Shift:** + Full Time **You Will Be Responsible For:** + Performs quality reviews on coded records to validate ICD-9, ... system as well as any area of weakness identified during the performance of coding validation reviews + Prepares statistical reports conveying the individual and… more
- R1 RCM (Chicago, IL)
- …and flexible in a work environment. **RESPONSIBILITIES** + Audit inpatient cases for DRG validation + Review inpatient medical records for validation ... operating costs and enhancing the patient experience. As our Inpatient Production Auditor , you will be responsible for auditing inpatient cases and reviewing… more
- UPMC (Pittsburgh, PA)
- …Microsoft Office products (Excel, Access, OneDrive, OneNote, and Word). + Experience with DRG Assignment and clinical validation of diagnoses. + Experience with ... UPMC Health Plan is looking for an Intermediate Clinical Auditor /Analyst to join the Quality Assurance team! This role will work standard daylight hours, Monday -… more
- Prime Healthcare (Ontario, CA)
- …record. Holding a senior coding position, assumes primary responsibility for DRG validation /accuracy, primary role in assisting CDS and medical staff members ... Coders or Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software. The Inpatient Coder Auditor ...Assisted Coding (CAC) software. The Inpatient Coder Auditor Trainee finalizes the coding and abstracting… 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