- Elevance Health (Houston, TX)
- Manager of DRG Coding Audit -Program/Project Locations: _The selected candidate must reside within a reasonable commuting distance of the designated ... eliminate and prevent unnecessary medical-expense spending. The ** Manager of DRG Coding Audit ** leads a high-performing team responsible for auditing… more
- Elevance Health (Houston, TX)
- …be so complex and advanced that disputes or appeals may only be reviewed by other DRG Coding Audit Principals (or Executives). **How you will make an ... : + BA/BS preferred. + Experience with vendor based DRG Coding / Clinical Validation Audit...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Elevance Health (Houston, TX)
- …Skills, Capabilities and Experiences** : + BA/BS preferred. + Experience with vendor based DRG Coding / Clinical Validation Audit setting or hospital ... ** DRG CODING AUDITOR** **_Virtual_** **_: _**...clinical guidelines and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding… more
- Elevance Health (Houston, TX)
- … Credential such as CCS or CIC. + Experience with third party DRG Coding and/or Clinical Validation Audits or hospital clinical documentation improvement ... **Title:** Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS- DRG , AP- DRG and APR- DRG )...clinical guidelines, and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding… more
- Molina Healthcare (Houston, TX)
- …proficiency. **PREFERRED QUALIFICATIONS:** + Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified ... readmissions. + Validates member medical records and claims submitted/correct coding , to ensure appropriate reimbursement to providers. + Resolves escalated… more