- Molina Healthcare (New York, NY)
- …predictive modeling, etc. + Experience with industry standard normalization/reimbursement methodologies (APR- DRG , MS- DRG , EAPG, APC) To all current Molina ... employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. \#PJHPO… more
- Hartford HealthCare (Farmington, CT)
- …with inpatient coders to determine appropriate Diagnosis Related Groups (MS- DRG , APR-DRGs, etc.) and ICD-10 code assignment for compliance, reimbursement, ... impact of CC/MCC's and other variables on the assignment of the various DRG methodologies. . Must be able to function independently. . Solid analytical capabilities.… more
- Corewell Health (Sterling Heights, MI)
- …record information. + Answers physicians/clinician questions regarding coding principles, DRG assignment and Prospective Payment System. Assists Finance, Data ... Processing and other departments with coding/ DRG issues. + Remains abreast of developments in medical record technology by pursuing a program of professional growth… more
- Veterans Affairs, Veterans Health Administration (West Roxbury, MA)
- …patient care. In addition, documentation should reflect documentation associated with MS- DRG assignment, case mix index, severity of illness, risk of mortality, ... a knowledge of complication or comorbidity/major complication or comorbidity (CC/MCC), MS- DRG structure, and POA indicators. vii. Knowledge of severity of illness,… more
- Oracle (Boston, MA)
- …requirements for accurate coding. + Practical experience using grouper software for MS- DRG and APR- DRG assignment. + Strong communication skills to interact ... effectively with the billing department regarding coding-related issues. + Stay abreast of the latest ICD-10-CM, ICD-10-PCS, HCPCS/CPT coding guidelines and updates. + Familiarity with 3M 360 or Optum HIM encoder software is preferred. + AHIMA Certified RHIA… more
- AmeriHealth Caritas (Newtown Square, PA)
- …for Newborn//Maternity Tracking Tool system updates of ICD-10, Diagnosis codes, CPT, DRG , and procedure codes; Modifiers, Part A codes and Revenue rate data. ... degree required. + 1 to 3 years knowledge of medical billing ICD-10, CPT DRG claims coding Revenue Code Mapping, Data Analysis, Data warehousing, translated 5010 EDI… more
- Baylor Scott & White Health (Temple, TX)
- …will be used to ensure accurate coding and grouping of classification assignment (eg, MS- DRG , APR- DRG , APC etc.) The Coder II will abstract and enter required ... data. **ESSENTIAL FUNCTIONS OF THE ROLE** Analyzes and interprets documentation from medical records and completes accurate coding of diagnosis, procedures and professional fees. Reviews diagnostic and procedure codes and charges in the applicable… more
- Northwell Health (Garden City, NY)
- …or Remote Job Responsibility 1.Leverages clinical expertise to identify and validate DRG code assignment. 2.Full review of CDI suggested code changes 3.Demonstrates ... codes on Medicare/non-Medicare charts for compliance to rules and conventions. 7.Communicates DRG changes and rationale to the coding and CDI staff. 8.Identifies… more
- University of Washington (Olympia, WA)
- …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 ... internal audits and partner with Compliance on external audit education + Review DRG and CPT claim denials for commercial payers and maintain written documentation… more
- US Tech Solutions (Columbia, SC)
- …or CPC. + A typical day would like in this role: The normal day is DRG reviews and audits. + Performs validation reviews of Diagnosis Related Groups ( DRG ), ... Adaptive Predictive Coding (APC), and Never Events (inexcusable outcomes in a healthcare setting) for all lines of business. Coordinates rate adjustments with claims areas. + Provides monthly and quarterly reports outlining trends. + Serves as a resource in… more