- Geisinger (Danville, PA)
- …severity and comply with standard provider coding regulations. + Carefully details review of documents such as laboratory findings, radiology reports, various scan ... Determines their sequencing to legally maximize reimbursement. + Assigns the appropriate DRG . + Assigns codes based on hospital and professional coding guidelines,… more
- Ascension Health (Elk Grove Village, IL)
- …reviews and assign a working Diagnosis Related Group. + Ensure the working DRG and other information are entered in the Clinical Documentation Improvement database. ... documentation issues prior to patient's discharge. + Maintain accurate records of review activities, ensuring reports and outcomes of CDI efforts are valid.… more
- Ascension Health (Pensacola, FL)
- …development and improvement activities related to case mix index, MS DRG and value-based purchasing reimbursement, and quality/outcomes and compliance requirements. ... + Manage the review of physician documentation to support a patient's level of care and appropriate assignation of Diagnosis Related Groups (DRGs), and develops… more
- Covenant Health Inc. (Knoxville, TN)
- …sequencing and assignment of ICD-10-CM and CPT codes. Confirms appropriate DRG assignment. Communicates with physicians for clarification of documentation for ... case mix reports on a weekly basis and follow-up on any record requiring re- review . + Participates in coding and abstracting quality reviews as required. + Assists… more
- Albany Medical Center (Albany, NY)
- …education and feedback, projects assigned by management, and special requests to review coding for external departments such as quality management and CDI. ... and CPT4 codes, abstract data elements for billing and reporting, and assign DRG , APC, and APG as appropriate. (High proficiency) + Highly skilled in team… more
- HCA Healthcare (San Antonio, TX)
- …Prepares and presents pertinent data to the Case Management committee (ie targeted DRG 's by LOS and cost/case, pertinent payment/resource issues, etc.) 5. Assists in ... apply for our Nurse Manager of Case Management opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. **Unlock… more
- WellSpan Health (York, PA)
- **General Summary** Collects, reviews, retrieves and codes data by careful review and analysis of documentation of inpatient medical records, assigning the ... program using 3M software and communicating with Clinical Documentation Specialist regarding DRG assignment. + Performs other duties that may be assigned by… more
- Commonwealth Care Alliance (Boston, MA)
- …and Quality Assurance, this role is responsible for the end-to-end review , analysis, and resolution of complex reimbursement issues - including underpayments, ... fee schedules, All-Payer Rate Setting regulations, and CMS payment methodologies (eg, DRG , APC, RBRVS). + Support provider appeal reviews and internal payment… more
- Veterans Affairs, Veterans Health Administration (Grand Junction, CO)
- …the office if the exception is not approved when it is up for review . Virtual: This is not a virtual position. Functional Statement #: 60088-O Relocation/Recruitment ... possess knowledge of complication or comorbidity/major complication or comorbidity (CC/MCC), MS- DRG structure, and POA indicators. Knowledge of severity of illness,… more
- Beth Israel Lahey Health (Charlestown, MA)
- …validation. + Evaluates documentation for assignment of working and possible DRG . + Recognizes opportunities for documentation improvement, including severity of ... + Performs mortality reviews and optimizes the risk of mortality. + Maintains review worksheet on all records using CDI software. + Ensures the accuracy of… more