- Cedars-Sinai (Beverly Hills, CA)
- …objectives. + May manage the research study intake process, including feasibility, review and endorsement and PRMC submission, as well as capturing all trials ... development of staff. **Department-Specific Responsibilities** + Manage Disease Research Group ( DRG ) Meetings: Lead and coordinate DRG meetings, ensuring that… more
- Houston Methodist (WA)
- …of clinical documentation. This position analyzes medical records for DRG 's, complications, and comorbidities; identifies trends; and notes observations and ... and follows up as necessary. Tracks responses and trends completion of DRG /Documentation worksheets as pertinent to scope of department. + Conducts follow-up reviews… more
- Carle Health (Champaign, IL)
- Overview Performs inpatient chart review to determine appropriate DRG assignment and assures appropriate documentation in the chart to support clinical care ... and secondary diagnoses, principal procedures, and assign the working DRG . Performs second level review of specific...assign the working DRG . Performs second level review of specific DRGs as assigned. Presents education related… more
- Kaleida Health (Buffalo, NY)
- …Management, Quality Department and ancillary staff to perform concurrent analytical review of clinical documentation and coding data.The CDS facilitates obtaining ... an accurate reflection of the patient condition in the associated DRG assignments, case-mix index, documentation/coded quality metrics, and reimbursement. The CDS… more
- Kaleida Health (Buffalo, NY)
- …Quality Department and ancillary staff to perform concurrent analytical review of clinical documentation and coding data. Facilitates obtaining appropriate ... an accurate reflection of the patient condition in the associated DRG assignments, case-mix index, documentation/coded quality metrics, and reimbursement. Exhibits a… more
- Penn Medicine (Philadelphia, PA)
- …diagnoses, principal procedure, and secondary procedures accurately. Performs analysis of the DRG assigned to produce the highest level of reimbursement to which the ... provider community. Assist the Revenue Cycle Manager by completing the preliminary DRG report for Finance, and compiling additional reports as needed to demonstrate… more
- Trinity Health (Livonia, MI)
- …severity of illness, risk of mortality, clinical validity and proper DRG assignment. **ESSENTIAL FUNCTIONS** Knows, understands, incorporates, and demonstrates the ... system goals are met. Maintains current knowledge of the MS- DRG system, CCs/MCCs, impact on quality, risk of mortality,...direct reports perform clinical validation as part of the review process and remain current on CDI strategies. Maintains… more
- Deloitte (Los Angeles, CA)
- …nurse, physician, physician assistant, case manager, clinical documentation specialist, utilization review , informatics RN, Quality, DRG Validation and health IT ... regarding clinical documentation standards and clinical indicators which drive reimbursement, MS- DRG , APR- DRG , PSIs, HACs, POA, Vizient, Elixhauser, public… more
- Penn Medicine (Philadelphia, PA)
- …diagnoses, principal procedure, and secondary procedures accurately. Performs analysis of the DRG assigned to produce the highest level of reimbursement to which the ... provider community. Assist the Revenue Cycle Manager by completing the preliminary DRG report for Finance, and compiling additional reports as needed to demonstrate… more
- Centene Corporation (New York, NY)
- …and a NYS Driver's License or Identification card.** **Position Purpose:** The Utilization Review Nurse I provides first level clinical review for all outpatient ... requiring authorization. Utilizes decision-making and critical-thinking skills in the review and determination of coverage for medically necessary health care… more