- Elevance Health (Richmond, VA)
- …and Experiences : BA/BS preferred. Experience with vendor based Diagnosis-Related Group ( DRG ) Coding /Clinical Validation Audit setting or hospital ... an Extraordinary Impact. Title : Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS- DRG , AP- DRG ...reside within a commuting distance from an office. The DRG Coding Auditor is responsible for auditing… more
- Elevance Health (Washington, DC)
- … Coding Credential such as CCS or CIC. Experience with third party DRG Coding and/or Clinical Validation Audits or hospital clinical documentation ... Title: Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS- DRG , AP- DRG...impact: Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance… more
- UnitedHealth Group (Dallas, TX)
- …or CIC certification within six months of hire 3+ years acute care Inpatient coding / DRG validation experience Proven understanding of health insurance and/or ... Join us to start Caring. Connecting. Growing together. The manager of a Waste and Error Operations oversees a...ranging from 15 - 20 direct reports. As a manager , General Management, you will be responsible for overseeing… more
- Christus Health (Woodworth, LA)
- …specific tools to support medical record physician documentation. Review clinical issues with coding staff to assign working DRG 's. Work collaboratively with the ... Nurse collaborates extensively with physicians, nursing staff, other patient caregivers and coding staff to improve the quality and completeness of documentation of… more
- Elevance Health (Hanover, MD)
- Manager of DRG Coding Audit-Program/Project Locations: _The selected candidate must reside within a reasonable commuting distance of the designated posting ... Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** Manager of DRG Coding Audit** leads a high-performing… more
- Elevance Health (Roanoke, VA)
- …Skills, Capabilities and Experiences** : + BA/BS preferred. + Experience with vendor based DRG Coding / Clinical Validation Audit setting or hospital ... ** DRG Coding Auditor Principal** **_Virtual: _**...billing/payment systems provider billing guidelines, payer reimbursement policies, billing validation criteria and coding terminology strongly preferred.… more
- Hartford HealthCare (Farmington, CT)
- …. Provide ongoing education to the coding and CDI teams regarding DRG validation , payer guidelines, and best practices to minimize future denials. . ... guidelines. *_Working Relationship:_* *This Job Reports To (Job Title):*HIM Manager Coding Quality and Education *Education* ....assignment, and payer regulations related to DRG validation . . Ability to analyze medical records, coding… more
- Marshfield Clinic (Marshfield, WI)
- …concerns and DRG assignments + Assists in the preparation of responses to DRG validation requests and other third party payer inquiries related to coding ... the most exciting missions in the world!** **Job Title:** Hospital Coding Specialist III (Remote) **Cost Center:** 101651098 System Support-Facility Coding… more
- Trinity Health (Livonia, MI)
- …or enterprise level desirable. Must have thorough knowledge of CMS regulations, coding guidelines and DRG reimbursement. Project management and/or system ... and education to clinical documentation specialists (CDS) to enhance clinical and coding skill sets and optimal utilization of 3M CDI software. Analyzes data… more
- Deloitte (Los Angeles, CA)
- …case manager , clinical documentation specialist, utilization review, informatics RN, Quality, DRG Validation and health IT preferred + Knowledge of Medicare ... improvement, and value-based payment models + Proven applicable CPT and ICD-10 coding experience; APR- DRG , MS- DRG and HCC assignment + Other revenue cycle… more
- Trinity Health (Livonia, MI)
- …integrity program is required. Must have thorough knowledge of CMS regulations, coding guidelines and DRG reimbursement. Demonstrated knowledge of state and ... PURPOSE** Work Remote Position At the direction of the Regional Manager , Clinical Documentation Integrity (CDI), this position supervises daily operations of… more
- Covenant Health Inc. (Knoxville, TN)
- …related to initial DRGs and updates to working DRGs and SOI/ROM for final coding and DRG assignment. + Prepares reports for any assigned facilities. Assists ... of documentation, and the appropriate assignment of a final DRG . The CDI Specialist functions as a resource for...federal regulations to ensure compliance. + Keeps current on coding guidelines and communicates to Health Information Manager… more
- Covenant Health Inc. (Knoxville, TN)
- …related to initial DRGs and updates to working DRGs and SOI/ROM for final coding and DRG assignment. + Prepares reports for any assigned facilities. Assists ... of documentation, and the appropriate assignment of a final DRG . The CDI Specialist functions as a resource for...federal regulations to ensure compliance. + Keeps current on coding guidelines and communicates to Health Information Manager… more
- Humana (Springfield, IL)
- …documentation to ensure capture of all relevant coding . Applies clinical and coding experience to conduct a clinical validation review of the inpatient ... put health first** The Nurse Auditor 2 performs clinical audit/ validation processes to ensure that medical record documentation and...- ex: RHIA, RHIT, CCS, CIS, CIC) + Inpatient coding claim experience + Prospective payment methodologies, DRG… more
- Molina Healthcare (NE)
- …care issues. + Assists with complex claim review including diagnosis-related group ( DRG ) validation , itemized bill review, appropriate level of care, inpatient ... readmissions. + Validates member medical records and claims submitted/correct coding , to ensure appropriate reimbursement to providers. + Resolves escalated… more
- Beth Israel Lahey Health (Charlestown, MA)
- …the medical record. The CDI Specialist II works under the direction of the Manager of CDI and collaborates with coding , clinicians, medical staff, and physician ... + Concurrently reviews inpatient records to ensure completeness, accuracy, and clinical validation . + Evaluates documentation for assignment of working and possible … more
