- Christus Health (Woodworth, LA)
- …coders on identifying all documented POA/HAC, diagnosis and procedures Updates DRG worksheet to reflect any changes to inpatient status/procedure/treatment ... and co-morbidities are a complete reflection of the patient's clinical status and care. Review final DRG and compare with clinical data gathered to ensure the… more
- Christus Health (Beaumont, TX)
- …documentation RN will provide support and expertise through comprehensive assessment and review of inpatient medical records. The clinical documentation RN will ... to assist coders on identifying all documented diagnosis and procedures Updates DRG worksheet to reflect any changes inpatient status/procedure/treatment and… more
- Christus Health (San Antonio, TX)
- …COP 482.43). Daily and concurrently involved in the management of inpatient and observation patients by comprehensive assessment, planning, interventions, and ... for PAN referrals. Proactively uses 3M report which assigns working MS/APR DRG in MIDAS daily, and queries, communicates and collaborates with nursing, physicians,… more
- Zelis (FL)
- …gained, and the personal interests that shape who you are. Position Overview The Inpatient DRG Reviewer will be primarily responsible for conducting ... post-service, pre-payment and post pay comprehensive inpatient DRG reviews based on...Clinic and client specific coverage policies. Conduct prompt claim review to support internal inventory management to achieve greatest… more
- Zelis (NJ)
- …this role is responsible for conducting post-service, pre-payment and post pay comprehensive inpatient DRG Quality Assurance reviews in an effort to increase the ... savings achieved for Zelis clients. Conduct reviews on inpatient DRG claims as they compare with medical records utilizing ICD-10 Official Coding Guidelines, AHA… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …development, leadership programs and more! **Description** We are seeking an experienced ** Inpatient DRG Coding Auditor** to extract data from patient encounters ... the accuracy of DRGs. This individual will: + Reviews inpatient medical records for select payer populations post-discharge and...nursing, and other clinical staff to improve documentation. + Review ?s DRG Reassignment letters and assists… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The DRG Denials Auditor conducts hospital inpatient DRG denial audits for both RAC and non-RAC accounts, reviewing patient records for ... to improve coding practices and compliance. **Essential Functions** + Performs inpatient denial reviews using ICD-10-CM/PCS and DRG validation utilizing… more
- Datavant (Annapolis, MD)
- …allowing you to help shape the future of healthcare from your own workspace! Seeking Inpatient Auditor proficient in MS- DRG and APR- DRG **What You Will Do:** ... function and decision making + Strong organizational, teamwork, and leadership skills Seeking Inpatient Auditor proficient in MS- DRG and APR- DRG **What You… more
- CareFirst (Baltimore, MD)
- …(all benefits/incentives are subject to eligibility requirements). **Department** Inpatient DRG Telephonic **Equal Employment Opportunity** CareFirst ... Navigator (RN) embedded at a partnering hospital will conduct concurrent review of inpatient level of care, managing the timely and smooth transition from… more
- CareFirst (Washington, DC)
- …(all benefits/incentives are subject to eligibility requirements). **Department** Inpatient DRG Telephonic **Equal Employment Opportunity** CareFirst ... Navigator (RN) embedded at a partnering hospital will conduct concurrent review of inpatient level of care, managing the timely and smooth transition from… more
- TEKsystems (Dallas, TX)
- …so they would like for everyone to have experience in emergency services, inpatient coding, or DRG (diagnosis-related group) coding. This would allow them ... MCMC. Then they pass it off to QA for review . They will do these cases over and over...guaranteed Certified Coding Specialist CCS) Experience or exposure to inpatient coding, emergency services coding or DRG … more
- CareFirst (Baltimore, MD)
- …(all benefits/incentives are subject to eligibility requirements). **Department** Inpatient DRG Telephonic **Equal Employment Opportunity** CareFirst ... County/Washington DC or Northern Virginia metropolitan area.** **PURPOSE:** The Inpatient Management Care Management Supervisor will direct and coordinate the… more
- Humana (Springfield, IL)
- …neonatal). For example: ICU, CCU, PCU, med-surg/adult units or a minimum of 2 years DRG Inpatient auditing. NOTE: Inpatient experience does **not** refer to ... relevant coding. Applies clinical and coding experience to conduct a clinical validation review of the inpatient medical record to validate billed diagnoses.… more
- Cleveland Clinic (Cleveland, OH)
- …including the ability to code and charge for interventional radiology procedures. ** Inpatient :** + Identify, review , and assign highly complex/high-acuity codes, ... including ICD-10-CM, PCS, POA and PSI indicators for inpatient charts. **Outpatient:** + Identify, review and...medical and surgical complications and untoward events for accurate MS- DRG /APR- DRG for inpatient charts… more
- Excellus BlueCross BlueShield (Rochester, NY)
- Job Description: Summary: The Payment Integrity DRG Coding & Clinical Validation Analyst position has an extensive background in acute facility-based clinical ... documentation, and/or inpatient coding and has a high level of understanding of the current MS- DRG , and APR- DRG payment systems. This position is responsible… more
- Elevance Health (Richmond, VA)
- …considered if candidates reside within a commuting distance from an office.** The ** DRG Coding Auditor** is responsible for auditing inpatient medical records ... and other documentation to evaluate issues of coding and DRG assignment accuracy. Specializes in review of...where additional recoveries may be available, such as re-admissions, Inpatient to Outpatient, and HACs. + Suggests and develops… more
- Elevance Health (Roanoke, VA)
- …spending. The ** DRG Coding Auditor Principal** is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group ( DRG ... all lines of business, and its clients. Specializes in review of DRG coding via medical record...where additional recoveries may be available, such as re-admissions, Inpatient to Outpatient, and Hospital Acquired Conditions (HACs), Preventable… more
- Insight Global (South Jordan, UT)
- Job Description Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100% remote. The work authorization is not specified and the salary ... have an extensive background in either facility-based nursing, clinical documentation, and/or inpatient coding and has a high level of understanding of reimbursement… more
- Elevance Health (Seattle, WA)
- …clinical documentation supports the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group ( DRG ) paid claims. **How you will ... **Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS- DRG , AP- DRG and APR- DRG )** **Virtual:** This role enables associates to work virtually… more
- Hartford HealthCare (Farmington, CT)
- …is responsible for reviewing, analyzing and appealing denials related to DRG (Diagnostic Related Group) downgrades. This role involves validating the coding ... address payer concerns. Key responsibilities include timely investigation of DRG downgrades, submitting appeals, coordinating follow-up actions and ensuring… more
