- Redeemer Health Home Care & Hospice (Meadowbrook, PA)
- …apply today. SUMMARY OF JOB The Clinical Documentation Specialist (CDS) performs concurrent review of the medical record to promote the integrity of the clinical ... clinical indicators and associated diagnostic terms that translate into ICD-10 /Working MS- DRG codes and reimbursable data to reflect the Severity of Illness (SOI),… more
- Houston Methodist (Houston, TX)
- …education **WORK EXPERIENCE** + Eight years of progressive coding and/or coding review (auditing) experience at a large facility or multi-facility + Some ... CPT) (for inpatient/outpatient coding) coding classification systems + For inpatient/outpatient coding: MS- DRG , APR DRG and APC assignment systems + Official… more
- Community Health Systems (Fort Wayne, IN)
- …required + Experience in ICU/Critical Care, case management, utilization review , quality, or inpatient coding preferred **Knowledge, Skills and Abilities** ... standards, and medical terminology + Proficient in ICD-10-CM/PCS coding principles, MS- DRG and APR- DRG assignment, and the IPPS system + Excellent verbal and… more
- Rochester Regional Health (Rochester, NY)
- …proven leadership and management skills to promote effective and efficient review of physician documentation and the medical record. + Demonstrate knowledge ... program compliance to ensure adherence to all CMS regulations regarding DRG assignment. + Assume responsibility for professional development through participation at… more
- Humana (St. Paul, MN)
- …guidance where needed. Follows established guidelines/procedures. **KEY ACCOUNTABILITIES** + Review medical documentation, obtain additional information that may be ... timeframes when physician is available for peer to peer review , and forward to physician review companies...guidelines + Working knowledge of ICD-9 or ICD-10, HCPCS, DRG use + Experience with TRICARE contracts and/or the… more
- Houston Methodist (Houston, TX)
- …This position is a key member and leader of the hospital's utilization review /management committee, which is charged with regulatory goals of ensuring high levels of ... length of stay, and quality issues. + Chair the utilization review /management committee, actively participates in defining operational strategic objectives for the… more
- Veterans Affairs, Veterans Health Administration (Spokane, WA)
- …database as well as all cost recovery programs. Performs a comprehensive review of the patient health record to abstract medical, surgical, ancillary, demographic, ... population, to determine budgetary requirements, to report to accrediting and peer review organizations, to bill insurance companies and other agencies, and to… more
- Stony Brook University (Stony Brook, NY)
- …to the Bone Marrow Transplant service. + Ensure procurement charges are coded into DRG . + Record keeping for the purchase and procurement of stem cell, bone marrow, ... cord blood, immune effector cells, and HLA typing. + Review charges with BMT Program Manager and manage care...or for a maximum of 90 days. An initial review of all applicants will occur two weeks from… more
- Catholic Health Services (Rockville Centre, NY)
- …care contracts, and healthcare finance. Key Responsibilities: + Prepare and review Medicare, Medicaid, and other third-party cost reports, ensuring accuracy and ... negotiate contract terms. + Monitor and interpret CMS updates, payment methodologies ( DRG , APC, OPPS, etc.), and value-based reimbursement models. + Perform variance… more
- TEKsystems (San Bernardino, CA)
- …have all the documentation to support it. medical necessity level of care, you know, DRG revisions, you know, delay in service, barren days, which is the same thing, ... two nurses. They're lvns and so, you know, that review them and see if we have enough clinical...we're going to accept it. So they do that review and then, you know, send the clinical appeal,… more