• Facility Coding Inpatient DRG Quality

    Banner Health (WA)
    …quality in the Inpatient Facility Coding department. If you have experience with DRG and PCS coding/denials/audits, we want to hear from you. **Requirements:** + **5 ... facility-based medical coding (clearly reflected in your attached resume);** + ** DRG and PCS Coding, Auditing experience;** + **Bachelors degree or equivalent;**… more
    Banner Health (09/06/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Seattle, WA)
    …clinical documentation supports the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group ( DRG ) paid claims. **How you will ... **Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS- DRG , AP- DRG and APR- DRG )** **Virtual:** This role enables associates to work virtually… more
    Elevance Health (08/23/25)
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  • Utilization Review RN

    Virginia Mason Franciscan Health (Bremerton, WA)
    …/ PURPOSE** **This will be a remote position.** Responsible for the review of medical records for appropriate admission status and continued hospitalization. Works ... in collaboration with the attending physician, consultants, second level physician reviewer and the Care Coordination staff utilizing evidence-based guidelines and… more
    Virginia Mason Franciscan Health (09/07/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Vancouver, WA)
    …+ Identifies and reports quality of care issues. + Assists with Complex Claim review including DRG Validation, Itemized Bill Review , Appropriate Level of ... set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing clinical knowledge and experience,… more
    Molina Healthcare (09/06/25)
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  • Clinical Documentation Specialist RN

    Houston Methodist (WA)
    …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
    Houston Methodist (08/13/25)
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  • Coding Quality Auditor

    Houston Methodist (WA)
    …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
    Houston Methodist (07/12/25)
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  • CDQI Nurse Specialist - Part Time - Remote

    Datavant (Olympia, WA)
    …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
    Datavant (09/04/25)
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  • Outpatient Coding Education Analyst

    University of Washington (Seattle, WA)
    …the results of internal audits and partner with Compliance on external audit education Review DRG and CPT claim denials for commercial payers and maintain ... as an expert in coding , respond to general coding questions (ICD, DRG , CPT and HCPCS), engage in the development and/or implementation of audit/monitoring plans,… more
    University of Washington (08/20/25)
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  • Inpatient Coding Education Analyst

    University of Washington (Seattle, WA)
    …results of internal audits and partner with Compliance on external audit education + Review DRG and CPT claim denials for commercial payers and maintain written ... an expert in Inpatient coding , respond to general coding questions (ICD, DRG , CPT and HCPCS), engage in the development and/or implementation of audit/monitoring… more
    University of Washington (08/20/25)
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  • Inpatient Audit Specialist

    Datavant (Olympia, WA)
    …reviews, using appropriate assignment of codes and other coding-related elements using MS DRG or APR DRGs. + Provides rich and concise rationale explaining the ... and/or auditing. + CCS (required), RHIA or RHIT preferred + Maintain 95% DRG accuracy rate + Experience with various software including Epic, Cerner, and other… more
    Datavant (08/13/25)
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