- Elevance Health (Tampa, FL)
- …Skills, Capabilities and Experiences** : + BA/BS preferred. + Experience with vendor based DRG Coding / Clinical Validation Audit setting or hospital ... ** DRG CODING AUDITOR** **_Virtual_** **_: _**...billing/payment systems provider billing guidelines, payer reimbursement policies, billing validation criteria and coding terminology preferred. +… more
- Elevance Health (FL)
- … Coding Credential such as CCS or CIC. + Experience with third party DRG Coding and/or Clinical Validation Audits or hospital clinical documentation ... **Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS- DRG , AP- DRG...+ Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance… more
- University of Miami (Medley, FL)
- … Coding Review Specialist (H) under the general direction of the Inpatient Coding Manager works closely with the University of Miami Health's Clinical ... Official Coding Guidelines, UHDDS, and regulatory requirements for accurate MS- DRG assignment. + Ensures accurate capture of Severity of Illness (SOI) and… more
- AdventHealth (Maitland, FL)
- … coding and reimbursement system and any weakness identified during the coding validation reviews. Qualifications **The expertise and experiences you'll need ... each year **The role you'll contribute:** Under the general supervision of the Coding Quality Manager , the Data Quality Reviewer is responsible for validating… more
- Deloitte (Tampa, FL)
- …case manager , clinical documentation specialist, utilization review, informatics RN, Quality, DRG Validation and health IT preferred + Knowledge of Medicare ... improvement, and value-based payment models + Proven applicable CPT and ICD-10 coding experience; APR- DRG , MS- DRG and HCC assignment + Other revenue cycle… more
- Molina Healthcare (FL)
- …care issues. + Assists with complex claim review including diagnosis-related group ( DRG ) validation , itemized bill review, appropriate level of care, inpatient ... Looking for a RN with experience with appeals, claims review, and medical coding . **Job Summary** Provides support for medical claim and internal appeals review… more