- 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
- Datavant (Tallahassee, FL)
- …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
- Humana (Tallahassee, FL)
- …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
- Elevance Health (Tampa, FL)
- …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 (Lake Mary, FL)
- …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
- Elevance Health (FL)
- …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
- HCA Healthcare (Ocala, FL)
- …organizations. Apply Today! **Job Summary and Qualifications** As a work from home Inpatient Coding Specialist, you will review and evaluate hospital ... and ICD-10- PCS codes. You will perform coding and/or code/ DRG validation across multiple entities. **What you will do...personal growth, we encourage you to apply for our Inpatient Coding Specialist opening. We promptly review … more
- Datavant (Tallahassee, FL)
- …on medical records, utilizing ICD-10-CM, CPT, and appropriate coding references for accurate DRG and APC assignment. + Review non-CC/MCC records to assess proper ... to realize our bold vision for healthcare. As an ** Inpatient Auditing Specialist** you will be instrumental in addressing... by the facility or CCS HIM director. + Review disagreements on APC/ DRG changes with the… more
- Cognizant (Tallahassee, FL)
- **Job Title: Medical Coder - Inpatient Hospital - ICD 10 CM/PCS (Remote)** **Location:** [Remote] **Employment Type:** [Full-time] M-F flexible hours An ** ... inpatient hospital medical coder** is a healthcare professional responsible...and **PCS** (Procedure Coding System) standards. . **Responsibilities** + Review clinical documentation to assign accurate **ICD-10-CM** and **ICD-10-PCS**… more
- Houston Methodist (FL)
- At Houston Methodist, the Inpatient Coder position is responsible for ensuring diagnostic and procedure codes are assigned accurately to inpatient encounters ... Responds promptly and appropriately to requests to code or review coded accounts for accuracy. + Initiates queries with...of degree **WORK EXPERIENCE** + One year of relevant inpatient coding experience or successful completion of the Houston… more
- Datavant (Tallahassee, FL)
- …for healthcare. **What We're Looking For** We're looking for experienced and credentialed inpatient coders to become an integral part of our team. The ideal ... coding accuracy rate and a 95% accuracy rate for MS- DRG assignments + Maintain site-specific productivity benchmarks + Foster...Succeed:** + A minimum of 3 years of recent inpatient coding facility experience + CCS, RHIT, or RHIA… more
- Houston Methodist (FL)
- …accuracy in code assignment of diagnosis and procedure to outpatient and/or inpatient encounters based upon documentation within the electronic medical record while ... rules and regulatory body guidelines. This position performs data quality review to ensure data integrity, coding accuracy, and revenue preservation. Additional… more
- Deloitte (Tampa, FL)
- …nurse, physician, physician assistant, case manager, clinical documentation specialist, utilization review , informatics RN, Quality, DRG Validation and health IT ... regarding clinical documentation standards and clinical indicators which drive reimbursement, MS- DRG , APR- DRG , PSIs, HACs, POA, Vizient, Elixhauser, public… more
- Molina Healthcare (Tampa, FL)
- … review including diagnosis-related group ( DRG ) validation, itemized bill review , appropriate level of care, inpatient readmission, and any opportunities ... **Job Description** **Job Summary** The Medical Review Nurse provides support for medical claim and...services provided, length of stay, level of care, and inpatient readmissions. + Validates member medical records and claims… more
- Datavant (Tallahassee, FL)
- …should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and appeal writing for inpatient admission. Experience with ... is to effectively defend utilization of available health services, review of admissions for medical necessity and necessity of...Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and appeal writing for inpatient… more
- Oracle (Tallahassee, FL)
- …of care, clinical validation) to lead the appeals initiative to review denied claims, create write-ups for appeals packets, identify trends/improvement opportunities ... Clinical Documentation Improvement experience. + Knowledge of medical and insurance terminology, MS- DRG , APR- DRG , CPT, ICD coding structures, and billing forms… more
- Datavant (Tallahassee, FL)
- …+ Conduct timely, accurate, and complete documentation reviews for selected inpatient records, addressing inadequate or conflicting documentation. + Collaborate with ... caregivers to ensure appropriate reimbursement and clinical severity for DRG -based payer patients. + Demonstrate understanding of complications, co-morbidities,… more
- Cardinal Health (Tallahassee, FL)
- …and adequacy of documentation and coding related to physician or hospital ( inpatient and outpatient) billing and/or medical necessity reviews. + Prepares written ... application of Medicare/Medicaid documentation and coding rules and guidelines; ICD/CPT/HCPCS/ DRG /APC documentation coding rules; medical terminology; E/M rules; healthcare… more