- Elevance Health (Houston, TX)
- …of the Company, for all lines of business, and its clients. Specializes in review of DRG coding via medical record and attending physician's statement provided ... ** DRG Coding Auditor Principal** **_Virtual: _** _ _...to recover, eliminate and prevent unnecessary medical-expense spending. The ** DRG Coding Auditor Principal** is responsible for auditing inpatient… more
- UTMB Health (Galveston, TX)
- …for proper coding of all pertinent diagnoses and procedures and to provide optimal DRG assignment after thorough review of medical record and analysis of ... Senior DRG Coder - RCO Coding **Galveston, Texas, United...or equivalent and three years of experience. The Sr. DRG coder must be proficient in inpatient coding with… more
- Insight Global (Plano, TX)
- Job Description Insight Global is seeking experienced DRG Auditors to join a remote healthcare organization. The DRG Revenue Integrity Auditor will perform ... Diagnostic Related Group ( DRG ) validation and quality audits on inpatient charts to ensure accurate coding and compliance with federal regulations. This is a remote… more
- Datavant (Austin, TX)
- …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
- Houston Methodist (Houston, TX)
- …of clinical documentation. This position analyzes medical records for DRG 's, complications, and comorbidities; identifies trends; and notes observations and ... and follows up as necessary. Tracks responses and trends completion of DRG /Documentation worksheets as pertinent to scope of department. + Conducts follow-up reviews… more
- Molina Healthcare (Dallas, TX)
- …Identifies and reports quality of care issues. + Assists with complex claim review including diagnosis-related group ( DRG ) validation, itemized bill review , ... **Job Description** **Job Summary** The Medical Review Nurse provides support for medical claim and...Nurse provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and… more
- Deloitte (Dallas, TX)
- …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
- Houston Methodist (Houston, TX)
- …rules and regulatory body guidelines. This position performs data quality review to ensure data integrity, coding accuracy, and revenue preservation. Additional ... duties include participating in quality review and performance improvement projects throughout the department and/or facility. **PEOPLE ESSENTIAL FUNCTIONS** +… more
- UTMB Health (Galveston, TX)
- …of inpatient ICD-10 coding guidelines and clinical documentation requirements to assign working MS- DRG . + Enter review information and working MS- DRG /APR- ... patient status that translates into coded data. **Job Duties:** + Concurrently review inpatient admissions to identify opportunities to clarify missing or incomplete… more
- Datavant (Austin, TX)
- …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