- Elevance Health (Waukesha, WI)
- …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 (Waukesha, WI)
- … 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** **Virtual:** This role enables associates to...and reimbursed. Specializes in review of Diagnosis Related Group ( DRG ) paid claims. **How you will make an impact:**… more
- Marshfield Clinic (Marshfield, WI)
- …concerns and DRG assignments + Assists in the preparation of responses to DRG validation requests and other third party payer inquiries related to coding ... the most exciting missions in the world!** **Job Title:** Hospital Coding Specialist III (Remote) **Cost Center:** 101651098 System Support-Facility Coding… more
- Molina Healthcare (Racine, WI)
- …reports quality of care issues. + Assists with Complex Claim review including DRG Validation , Itemized Bill Review, Appropriate Level of Care, Inpatient ... appropriate level of care utilizing MCG/InterQual, state/federal guidelines, billing and coding regulations, and Molina policies; validates the medical record and… more