- Independent Health (Buffalo, NY)
- …Demonstrated understanding of reimbursement methodologies and underlying coding requirements (eg, DRG , CPT, & ICD9) as deployed across provider networks and ... services. + Conduct analyses of: + Provider networks + Medical cost and utilization trends and drivers + Utilization patterns using statistical tools + Provider patterns and profiles + Provider reimbursement models and fee change models + Advise and make… more
- WMCHealth (Valhalla, NY)
- …medical record. + Ensures that all factors necessary for assigning an accurate DRG are present, and that all diagnoses are ranked properly. + Makes appropriate ... contacts in order to acquire or clarify necessary information. + Enters final diagnostic code numbers and narrative descriptions of diagnoses and procedures into an automated grouper system. + Provides information to and responds to inquiries regarding medical… more
- Intermountain Health (Albany, NY)
- …to assign ICD-10 CM diagnosis and procedure codes with the appropriate DRG assignment for inpatient encounters, ICD-10-CM diagnosis and procedure codes, CPT-4 ... procedure codes, and APC assignment for outpatient encounters. This is to ensure a valid database used for research, reporting, quality improvement activities, reduce days not final billed (DNFB), and appropriate reimbursement. Scope 1.Assigns ICD, CPT and… more
- Catholic Health Services (Smithtown, NY)
- …ED charge nurse, and ED physicians to identify possible admissions. Determines DRG -based initial LOS values for ED admissions (all status/types). Partners with ED ... nurse, ED charge nurse, and ED physician to communicate with patients about their admission and plan of care. QUALIFICATIONS: Graduate of an accredited school of nursing required. Bachelor's Degree in Nursing (BSN) preferred. Current New York State RN License… more
- MVP Health Care (Schenectady, NY)
- …Documentation Accuracy** + Ensure correct coding and reimbursement aligned with ICD-10, CPT/HCPCS, DRG , and CMS guidelines. + Serve as a subject matter expert on ... complex coding issues and documentation standards. + Provide training and oversight to internal teams and vendors on coding compliance. **Regulatory & Industry Engagement** + Integrate payment integrity efforts with care quality initiatives, including… more
- CenterWell (Albany, NY)
- …action. The Medical Coding Professional confirms appropriate diagnosis related group ( DRG ) assignments. Analyzes, enters and manipulates database. Responds to or ... clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous… more
- Datavant (Albany, NY)
- …with strong problem-solving skills. + Expert knowledge of coding guidelines, DRG assignment, and reimbursement methodology. + Strong analytical and problem-solving ... abilities. + Effective communication and leadership skills. + Proficiency in productivity and audit tracking tools. + Strong Prioritization and Time Management Skills **What We Offer** + Benefits for Full-Time employees: Medical, Dental, Vision, 401k Savings… more
- Northwell Health (Lake Success, NY)
- …coding questions. 8.Demonstrates knowledge of ICD-10 CM and ICD-10 PCS coding, MS- DRG and APR NY and APR National grouper logic, documentation opportunities, ... clinical documentation requirements, and compliance to regulatory and facility policies and procedures. 9.Conducts follow-up reviews of clinical documentation to ensure points of clarification have been recorded in the patient's chart. 10.Reconciles reviewed… more
- Catholic Health Services (Bethpage, NY)
- …determine whether MCG criteria is met. Engage physicians to establish the optimal DRG , length of stay and expected date of discharge. Interface with representatives ... of third party payors to assist with the certification process and the discharge planning process, responding to requests for reviews in a timely fashion to avoid denials. Review records and collaborate with the interdisciplinary team to obtain information… more
- SMBC (New York, NY)
- …competitive portfolio of benefits to its employees. **Role Description** Distribution Risk Group ( DRG ) is seeking a risk management Vice President to play an active ... role in assisting with the risk management of loan and bond underwriting risk and CLO warehouse financing (referred to at SMBC as distribution risk). The group covers distribution risk for the full spectrum of SMBC's products. The individual would support… more