- Stony Brook University (Commack, NY)
- …ICD-10CM-PCS diagnostic and procedural codes for designated service lines. Working knowledge of MS- DRG and NYS APR DRG grouping logic to accurately reflect the ... diagnosis/procedures documented in the medical record. Documentation assessment and review for accurate abstracting of clinical data to meet regulatory and compliance requirements. + Other duties as assigned. **Qualifications** **Required Qualifications:**… more
- UHS (Binghamton, NY)
- …codes for inpatient discharges. You will ensure proper grouping to the appropriate MS- DRG or APR Grouper while adhering to coding and reimbursement guidelines with ... codes accurately to inpatient records, ensuring correct grouping into APR or MS- DRG categories according to organizational policy and coding guidelines + Complete… more
- Glens Falls Hospital (Albany, NY)
- …abstracts and validates inpatient and / or ambulatory records. Determines appropriate DRG assignment and code sequencing using ICD- 9-CM and CPT-4 coding guidelines ... ICD-9-CM and / or CPT-4 codes. * Groups the visits to the appropriate DRG / APG / APC using the 3M-Encoder and sequencing knowledge, optimizing after assignment… more
- Molina Healthcare (NY)
- …risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups ( DRG 's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), ... and other payment mechanisms. * Understanding of value-based risk arrangements + Experience in quantifying, measuring, and analyzing financial, operational, and/or utilization metrics in healthcare + Ability to mine and manage information from large data… more
- University of Rochester (Albany, NY)
- …accordance with applicable coding rules and policies (eg ICD-10, CPT-4, HCPCS, DRG ). Analyzes, enters and manipulates database. Responds to or clarifies internal ... requests for medical information. **ESSENTIAL FUNCTIONS** + Uses thorough knowledge of coding systems and system logic to review codes created by electronic charge capture and/or assign codes (ICD-10-CM, E/M, CPT, HCPCS and modifiers) through medical record… more
- The Davey Tree Expert Company (Rochester, NY)
- …by law. Utility Asset Management is a division of Davey Resource Group, Inc. ( DRG ), a Davey company. Davey has been employee-owned since 1979. Our engineering, field ... services, inspection, and construction teams help keep the world connected, supporting the infrastructure of our electric utility and communications partners. The Davey Tree Expert Company provides research-driven tree services, grounds maintenance and… more
- Guthrie (Binghamton, NY)
- …through analysis of clinical and financial data, including length of stay and DRG profiling. Education, License & Cert: RN Bachelor of Science degree in Nursing ... (BSN) or, a Bachelor of Arts (BA) degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant experience willing to pursue a BSN or BA degree will be considered. Must obtain BSN within two (2) years of hire. Individual… more
- Molina Healthcare (Albany, NY)
- …risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups ( DRG 's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), ... and other payment mechanisms. * Understanding of value-based risk arrangements + Experience in quantifying, measuring, and analyzing financial, operational, and/or utilization metrics in healthcare To all current Molina employees: If you are interested in… more
- Cardinal Health (Albany, NY)
- …and Medicaid documentation and coding rules and guidelines; ICD/CPT/HCPCS/ DRG /APC documentation coding rules; charge capture and reimbursement methodologies; ... medical terminology; E/M rules, teaching physician guidelines, and/or medical necessity defense reviews; healthcare compliance audit methodology, principles and techniques; CMS manuals; professional and/or hospital services reimbursement and repayment;… more
- Mohawk Valley Health System (Utica, NY)
- …claims. + Determines whether payment from insurance billed is accurate, based on DRG , Contracted Rate, Per Diem, or Fee Schedule. Initiates an adjustment, if ... necessary, to bring account to the correct balance. Demonstrates thorough knowledge of rates for specific payor responsibility and advises management of any trends regarding inappropriate payments. + Maintains account receivables for the Business Office. Makes… more