- HSS (New York, NY)
- …committed to our Mission, you too can be part of our transformation across the enterprise. DRG Reviewer Full-Time The DRG Reviewer reports to the ... Director of Coding, HIM (Health Information Management). The DRG Reviewer oversees DRG accuracy....+ Monitors coding and documentation accuracy. + Conducts retrospective review of the medical record to increase accuracy, clarity,… more
- The Mount Sinai Health System (New York, NY)
- Maintains responsibility for coding/ DRG validation review , DRG PRO activities and assurance of optimal reimbursement. Oversees compliance with coding ... standards and regulations **Strength Through Diversity** The Mount Sinai Health System believes that diversity, equity, and inclusion are key drivers for excellence. We share a common devotion to delivering exceptional patient care. When you join us, you… more
- Hackensack Meridian Health (Red Bank, NJ)
- …admissions and observations as specified by the facility's Utilization Management/ Review Committee for documentation completeness and compliance with patient status. ... the medical screening process by documenting appropriateness of patient admission, working DRG & LOS information on worksheet and computer system as appropriate. +… more
- Banner Health (New York, NY)
- …identify possible opportunities for improvement of clinical documentation and accurate MS- DRG , Ambulatory Payment Classification (APC) or ICD-9 assignments on health ... and its impact on reimbursement under Medicare Severity Adjusted System (MS- DRG ), and Ambulatory Payment Classification (APC) or utilized operational systems… more
- Hackensack Meridian Health (Perth Amboy, NJ)
- …and ICD-10-Procedure Coding System (PCS) codes creating diagnosis-related group ( DRG ) assignments. Abstracts pertinent information from patient records. + Sequence ... the diagnosis and procedures using coding guidelines and optimizing the DRG as applicable. + Addressing all edits, including but not limited to nosology, Exihauser,… more
- Hackensack Meridian Health (Hasbrouck Heights, NJ)
- …BI reports to the appropriate leaders and supervisor the ultimate delegation to review and subsequent staff assignment. + Performs data mining and in depth analysis ... Manage Governmental denials - work closely with Case Management, Utilization Review , Physician Advisors, Registration/Access & other departments that have impact on… more
- The Mount Sinai Health System (New York, NY)
- …medicine. Healing made personal. **_Roles & Responsibilities:_** Responsible for the review and coding of complex inpatient and/or ambulatory surgery records ... preferred. Experience: Proficiency in the use of automated coding and DRG /AOC grouping software. **_Strength Through Diversity_** The Mount Sinai Health System… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …and identifying any deficiencies. + Prepare summaries for management of quality review results, including basic analysis of identified trends. + Analyzes audit ... for workflow enhancements. + Evaluates Prospective Payment System (PPS) (eg APC, DRG , etc.) grouping and pricing information. + Meets individual and departmental… more
- Atlantic Health System (Morristown, NJ)
- …of previous experience preferred + Familiarity with ICD9, ICD-10, preferred, CPT codes and DRG 's + Ability to analyze a UB04 and Explanation of Benefits + Computer ... - Becker's Healthcare + 100 Accountable Care Organizations to Know - Becker's Hospital Review + Best Employers for Workers over 50 - AARP + Gold-Level "Well… more
- Hackensack Meridian Health (Hasbrouck Heights, NJ)
- …& aligned with established Desktop & policies & procedures. + Performs analytical review of denials to support Revenue Operations, Case Management, Access, and other ... Managed Care, the payer, or DTS. Monitors payments denials and initiates CPT or DRG analysis to determine reasons for denial. + Monitors daily dashboard and reports… more