- Zelis (FL)
- …personal interests that shape who you are. Position Overview The Inpatient DRG Reviewer will be primarily responsible for conducting post-service, pre-payment and ... post pay comprehensive inpatient DRG reviews based on industry standard inpatient coding guidelines...criteria plan, and policy exclusions. Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10… more
- Elevance Health (Chicago, IL)
- ** DRG Coding Auditor Principal** **_Virtual: _** _ _ This role enables associates to work virtually full-time, with the exception of required in-person training ... determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** DRG Coding Auditor Principal** is responsible for auditing inpatient medical… more
- Elevance Health (Ashburn, VA)
- …medical-expense spending. **Build the Possibilities. Make an Extraordinary Impact.** **Title** : DRG Coding Auditor (ICD-9/10CM, MS- DRG , AP- DRG , APR- DRG ... reside within a commuting distance from an office.** The ** DRG Coding Auditor** is responsible for auditing inpatient medical...and other documentation to evaluate issues of coding and DRG assignment accuracy. Specializes in review of DRG… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …leadership programs and more! **Description** We are seeking an experienced **Inpatient DRG Coding Auditor** to extract data from patient encounters ensuring the ... the accuracy and completeness of diagnosis and procedure coding, DRG assignment, and abstracted data POA, Discharge Disposition. +...+ Reviews discrepancies between the Clinical Documentation Specialist (CDS) DRG and the Coder DRG . + Reviews… more
- Hartford HealthCare (Farmington, CT)
- …is responsible for reviewing, analyzing and appealing denials related to DRG (Diagnostic Related Group) downgrades. This role involves validating the coding ... address payer concerns. Key responsibilities include timely investigation of DRG downgrades, submitting appeals, coordinating follow-up actions and ensuring… more
- Excellus BlueCross BlueShield (Rochester, NY)
- Job Description: Summary: The Payment Integrity DRG Coding & Clinical Validation Analyst position has an extensive background in acute facility-based clinical ... coding and has a high level of understanding of the current MS- DRG , and APR- DRG payment systems. This position is responsible for reviewing medical records for… more
- Insight Global (South Jordan, UT)
- Job Description Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100% remote. This person should have an extensive background in ... of understanding of reimbursement guidelines specifically an understanding of the MS- DRG , AP- DRG , and APR- DRG payment systems. This position is responsible… more
- Zelis (St. Petersburg, FL)
- …the personal interests that shape who you are. Position Overview At Zelis, the DRG Clinical Dispute Reviewer role is responsible for the resolution of facility and ... provider disputes as they relate to DRG validation. They will be responsible for reviewing facility...ensure adherence to proper coding and billing, analyzing inpatient DRG claims based on industry standard inpatient coding guidelines,… more
- Zelis (NJ)
- …is responsible for conducting post-service, pre-payment and post pay comprehensive inpatient DRG Quality Assurance reviews in an effort to increase the savings ... achieved for Zelis clients. Conduct reviews on inpatient DRG claims as they compare with medical records utilizing ICD-10 Official Coding Guidelines, AHA Coding… more
- Elevance Health (Indianapolis, IN)
- **Title:** Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS- DRG , AP- DRG and APR- DRG ) **Virtual:** This role enables associates to work ... and reimbursed. Specializes in review of Diagnosis Related Group ( DRG ) paid claims. **How you will make an impact:**...minimum of 5 years of experience working with ICD-9/10CM, MS- DRG , AP- DRG and APR- DRG ; or… more