- Ankura (Nashville, TN)
- …Analyze healthcare-specific operational metrics (eg, patient volumes, length of stay, DRG classifications, case mix) to identify key business drivers and performance ... trends. + Strategic Modeling & Forecasting: Develop robust financial models, business cases, and ROI analyses to evaluate capital investments, strategic initiatives, and inform demand forecasting. + Executive Communication & Visualization: Translate complex… more
- McLaren Health Care (Macomb, MI)
- …utilization management nurse and obtains orders from providers. 5. Reviews current DRG /LOS identified within Cerner to assess discharge planning needs with providers ... and identifies which family member is the point of contact. 6. Assesses risk of readmission for specified patient populations and initiates assigned interventions that will enhance the patient's ability to successfully transition along the care continuum. 7.… more
- Community Health Systems (Franklin, TN)
- …payer representatives. + Knowledge of medical coding systems (ICD-10, CPT, HCPCS, DRG , etc.) and how they affect claim adjudication. + Strong organizational skills, ... with the ability to manage multiple projects and deadlines. + Proficient in Google and Microsoft Office Suite, with intermediate to advanced Excel skills. We know it's not just about finding a job. It's about finding a place where you are respected, valued and… more
- Ascension Health (Fishers, IN)
- …codes, creating Ambulatory Patient Classification (APC) or Diagnosis-Related Group ( DRG ) assignments. + Perform complex coding. + Obtain acceptable ... productivity/quality rates as defined per coding policy. + Query physicians when code assignments are not straight forward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes. + Maintain knowledge of, comply with and keeps… more
- University of Utah (Salt Lake City, UT)
- …Medicare Parts A and B), and ICD -10, CPT , HCPCS , DRG coding; proficient with word processing, spreadsheet and related computer applications; demonstrated human ... relations and effective communication skills also required. + Certification from the Healthcare Compliance Association ( HCCA ) as a Compliance Officer and clinical degree and experience is preferred. + Applicants must demonstrate the potential ability to… more
- University of Utah (Salt Lake City, UT)
- …policies and requirements (including Medicare Parts A and B), and ICD -10, CPT , HCPCS , DRG coding. 4. Coding certification ( CPC , CPC -H, ACS , CCS -P/H, RHIA ). ... If not current, must be willing to obtain within the first six months of employment. 5. Certified in Healthcare Compliance ( CHC ) from the Health Care Compliance Association ( HCCA ). If not current, must be willing to obtain within the first six months of… more
- Ascension Health (Austin, TX)
- …(HCPCS) codes, creating Ambulatory Patient Classification (APC) orDiagnosis-Related Group ( DRG ) assignments. + Perform complex coding. + Obtain acceptable ... productivity/quality rates as defined per coding policy. + Query physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes. + Maintain knowledge of, comply with and keep… more
- Scripps Health (San Diego, CA)
- …government health insurance and billing guidelines, ACA requirements, understanding of DRG 's, Medical ICD9/ICD10 codes and CPT/HCPC Codes and Modifiers. **Job:** ... **Business Office* **Organization:** **Scripps Clinic* **Title:** *Patient Service Representative - Float Pool - Carmel Valley* **Location:** *Central San Diego County-SAN DIEGO-SCRIPPS CLINIC - CARMEL VALLEY* **Requisition ID:** *262001036* more
- Commonwealth of Pennsylvania (PA)
- …Full-Time Job Number CS-2025-36830-L0686 Department Local Government Division DA Delaware Co Drg Alchl Abs U Opening Date 12/26/2025 Closing Date 1/8/2026 11:59 PM ... Eastern Job Code L0686 Position Number 80007764 Union Non-Union Bargaining Unit LG Pay Group LG Bureau / Division Code 88746023 Bureau / Division DA Delaware County Drug Alcohol Abuse Unit Worksite Address 4990 State Road, Suite 101 City Drexel Hill,… more
- Centene Corporation (New York, NY)
- …and its effect on inpatient claims payment. Chart review will include DRG pre-payment review, hospital readmission review and outlier payment review. + Analyze ... moderately complex health care information; reviews medical records; integrate medical coding and reimbursement rules; provide pricing guidance. + Ensure medical coding rules and regulations including compliance requirements are adhered to for the appropriate… more