- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of ... all diagnosis and procedure codes to assure properly assigned MS- DRG or APR- DRG for the purpose of...appropriate reimbursement. + Work with the physician advisor in review of patient medical records identified by RAC/MIC/QIO and… more
- Datavant (Harrisburg, PA)
- …the future of healthcare from your own workspace! Seeking Inpatient Auditor proficient in MS- DRG and APR- DRG **What You Will Do:** + Performs Inpatient Facility ... reviews, using appropriate assignment of codes and other coding-related elements using MS DRG or APR DRGs. + Provides rich and concise rationale explaining the… more
- St. Luke's University Health Network (Allentown, PA)
- …records identified by RAC/MIC/CGI/QIO and other outside auditors in retrospective reviews for DRG and coding-related issues. May participate in review of other ... all diagnosis and procedure codes to assure properly assigned MS- DRG for the purposes of appealing proposed MS- DRG...MS- DRG for the purposes of appealing proposed MS- DRG and coding changes by insurance providers or their… more
- Deloitte (Philadelphia, PA)
- …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
- UPMC (Pittsburgh, PA)
- …experience preferred. + Knowledge of computer technology, quality assurance activities, DRG , Quality Insights/Utilization review background is highly preferred. ... mix, secondary diagnosis, impact of procedures on the final DRG , and an ability to impart this knowledge to...critical care in conjunction with an expanded knowledge of DRG 's; OR completion of Health Records Administration program (RHIA)… more
- Penn Medicine (Philadelphia, PA)
- …diagnoses, principal procedure, and secondary procedures accurately. Performs analysis of the DRG assigned to produce the highest level of reimbursement to which the ... provider community. Assist the Revenue Cycle Manager by completing the preliminary DRG report for Finance, and compiling additional reports as needed to demonstrate… more
- Penn Medicine (Philadelphia, PA)
- …diagnoses, principal procedure, and secondary procedures accurately. Performs analysis of the DRG assigned to produce the highest level of reimbursement to which the ... provider community. Assist the Revenue Cycle Manager by completing the preliminary DRG report for Finance, and compiling additional reports as needed to demonstrate… more
- Penn Medicine (Philadelphia, PA)
- …are charted appropriately within defined regulatory timeframes + Assign a working MS- DRG upon initial admission review , and communicate with Physician or ... to reflect truth in diagnostic reflection. **Responsibilities:** + Direct review of patient charts to audit clarity and full...abstraction of clinical indicators, and the assignment of Initial DRG and Working DRG + Generate compliant… more
- Penn Medicine (Lititz, PA)
- …compliance with regulations, and accuracy for clinical care analysis and provider profiling. Review coded medical records for coding and DRG accuracy by ... new coding staff and cross training to existing staff as needed. + Research, review and respond to coding and coding quality issues and questions from various… more
- Penn Medicine (Philadelphia, PA)
- …diagnoses, principal procedure, and secondary procedures accurately. Performs analysis of the DRG assigned to produce the highest level of reimbursement to which the ... Sequences the diagnoses & procedures to obtain the optimal DRG or APR- DRG assignment and demonstrates 95%...Missing Pathology Report + Physician Query Needed + Death Review + Discharge Disposition + Missing Other Reports (Card… more