- Elevance Health (Walnut Creek, CA)
- **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS- DRG , AP- DRG and APR- DRG )** **Virtual:** This role enables associates to work virtually ... granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure clinical… more
- Highmark Health (Sacramento, CA)
- …II code and modifier assignments, ICD diagnosis and procedure coding, DRG /APC structure according to regulatory requirements. Reports findings both verbally and ... systems, missed secondary diagnoses and procedures and ensures compliance with DRG /APC structure and regulatory requirements. Performs periodic claim form reviews to… more
- Humana (Sacramento, CA)
- …Inpatient Medical Coding Professional confirms appropriate diagnosis related group ( DRG ) assignments. Analyzes, enters and manipulates database. Responds to or ... clarifies internal requests for medical information. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises… more
- Datavant (Sacramento, CA)
- …shape the future of healthcare from your own workspace! Preferred: Strong IP Auditor 3+ years experience, Cerner/3M a plus. Must have experience with onboarding QA, ... assignment of codes and other coding-related elements using MS DRG or APR DRGs. + Provides rich and concise...Strong organizational, teamwork, and leadership skills Preferred: Strong IP Auditor 3+ years experience, Cerner/3M a plus. Must have… more
- Datavant (Sacramento, CA)
- …with ICD-10-CM/PCS and MS-DRGs. + Minimum 1-2 years in a coding lead, auditor , or supervisory role. + Associate's degree in Health Information Management, or related ... with strong problem-solving skills. + Expert knowledge of coding guidelines, DRG assignment, and reimbursement methodology. + Strong analytical and problem-solving… more