- 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
- 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 ... data and coding on all diagnosis and procedure codes to assure properly assigned MS- DRG for the purposes of appealing proposed MS- DRG and coding changes by… 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 ... + Position Summary: : Codes and abstracts information from inpatient and outpatient records by careful analysis and adherence...cross training to existing staff as needed. + Research, review and respond to coding and coding quality issues… 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%...the following guidelines: + HUP - Average of 7.5-11.5 inpatient records coded daily + PPMC - Average of… 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
- Intermountain Health (Harrisburg, PA)
- …Integrity (CDI) Registered Nurses (RN) and Intermountain Physician Advisors to review complex facility encounters and assign International Classification of Diseases ... ICD-10 and Diagnosis Related Groups ( DRG ) codes for claims concurrently while a patient is...reviews while patients are hospitalized. It aids in the review of quality measures including Patient Safety Indicators and… more
- Geisinger (Danville, PA)
- …The 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 ... experience is required. BSN is strongly preferred. Job Duties: + Reviews inpatient medical records within 24-48 hours of admission for a specified patient… 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
- Datavant (Harrisburg, PA)
- …should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and appeal writing for inpatient admission. Experience with ... is to effectively defend utilization of available health services, review of admissions for medical necessity and necessity of...Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and appeal writing for inpatient… more
- Penn Medicine (Lititz, PA)
- …work? Summary: + Position Summary: : Codes and abstracts information from inpatient and outpatient records by careful analysis and adherence to official coding ... procedure codes with appropriate present on admission indicators to inpatient records, based upon the practitioner clinical documentation. Determines appropriate… more
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