- 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 ... determined by audits. + Sequences the diagnoses & procedures to obtain the optimal DRG or APR- DRG assignment and demonstrates 95% accuracy as determined by… more
- Geisinger (Danville, PA)
- …core of the program uses highly trained staff members to perform a concurrent inpatient review of the record. This allows the record to be coded post discharge in a ... the principal diagnosis, relevant secondary diagnoses, and procedures for accurate DRG assignment, risk of mortality, severity of illness; and initiate documentation… more
- St. Luke's University Health Network (Allentown, PA)
- …concurrent, prospective and retrospective coding audit activities. The incumbent will also review and validate coded medical records of the Professional Coding (PC) ... determine data quality and accuracy of coding, billing, and documentation related to DRG 's, CPT, APC's, and HCPCS Level II code and modifier assignments, ICD… more
- UPMC (Pittsburgh, PA)
- …and/or clarification to accurately complete the coding process. Consult with DRG Specialist when applicable during query process. + Incorporate into departmental ... and secondary diagnoses as reviewed by the designated trainer and/or the DRG Specialist. Coder should meet appropriate coding productivity standards within the time… more
- Select Medical (Mechanicsburg, PA)
- …studies, as well as data quality reviews or other documentation audits. + Perform peer review of codes and DRG assignment. + Keep knowledge of coding and ... CCS or CPC-H credentials. + Experience in ICD-10-CM diagnoses, procedure coding and DRG validation. + One or more years of experience with inpatient hospital medical… more
- Penn Medicine (Philadelphia, PA)
- …Remote / 150 Monument Rd 4th Floor Bala Cynwyd Hours: M-F, 8a-430p or similar Review coded medical records for coding and DRG and/or Evaluation and Management ... areas: subject focused, purely randomized, CPT-4 Coding, Systemic Monitoring and Review Technology (SMART) audits on 100% flagged records, discharge disposition code… more
- Datavant (Harrisburg, PA)
- …on medical records, utilizing ICD-10-CM, CPT, and appropriate coding references for accurate DRG and APC assignment. + Review non-CC/MCC records to assess proper ... for review by the facility or CCS HIM director. + Review disagreements on APC/ DRG changes with the appropriate manager. + Prepare the final reports for the… more
- Datavant (Harrisburg, PA)
- …Prevention Specialist is to effectively defend utilization of available health services, review of admissions for medical necessity and necessity of continued stay ... should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and appeal writing for inpatient admission. Experience with clinical… more
- Datavant (Harrisburg, PA)
- …caregivers to ensure appropriate reimbursement and clinical severity for DRG -based payer patients. + Demonstrate understanding of complications, co-morbidities, ... risk of mortality, case mix index, secondary diagnoses, and procedure impact on DRG . + Improve coding specificity by educating physicians and caregivers on the… more
- Penn Medicine (Lititz, PA)
- …upon the practitioner clinical documentation. Determines appropriate MS-Diagnostic Related Group DRG based upon diagnoses and procedure codes assigned. + Assigns ... from inpatient and outpatient records. + Participates in data quality peer review process, reviewing records according to established procedure. + The following… more
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