- Queen's Health System (Honolulu, HI)
- …knowledge of Medicare, Medicaid, Third Party payor requirements. SNF/ICF, ICD-9/ICD-10 and DRG . * Prior experience in report preparation and analysis. * Experience ... to demonstrate effective written and oral communication skills and interpersonal skills. * Experience to demonstrate ability to lead/conduct meetings with other departments and staff. * Experience with Windows applications, such as Word, Excel, etc. *… more
- Commonwealth Care Alliance (Boston, MA)
- …fee schedules, All-Payer Rate Setting regulations, and CMS payment methodologies (eg, DRG , APC, RBRVS). + Support provider appeal reviews and internal payment ... integrity investigations by providing reimbursement validation. + Escalate systemic or high-impact discrepancies to the Director of Claims Operations and Quality Assurance for further investigation or configuration updates. + Document all research, findings,… more
- Northwell Health (Lake Success, NY)
- …coding questions. 8.Demonstrates knowledge of ICD-10 CM and ICD-10 PCS coding, MS- DRG and APR NY and APR National grouper logic, documentation opportunities, ... clinical documentation requirements, and compliance to regulatory and facility policies and procedures. 9.Conducts follow-up reviews of clinical documentation to ensure points of clarification have been recorded in the patient's chart. 10.Reconciles reviewed… more
- SMBC (New York, NY)
- …competitive portfolio of benefits to its employees. **Role Description** Distribution Risk Group ( DRG ) is seeking a risk management Vice President to play an active ... role in assisting with the risk management of loan and bond underwriting risk and CLO warehouse financing (referred to at SMBC as distribution risk). The group covers distribution risk for the full spectrum of SMBC's products. The individual would support… more
- Hartford HealthCare (Farmington, CT)
- …alpha numeric diagnosis/procedure codes and Medicare Severity Diagnosis Related Groups (MS- DRG ). Data is classified for internal and external statistical reporting, ... and/or encoder, coding manuals and other reference material. 3. Reviews DRG assigned to each record. Enters coded/abstracted information into software, analyzes… more
- Trinity Health (Livonia, MI)
- …and secondary procedures. Assigns appropriate Medicare Severity Diagnosis Related Groups (MS- DRG ), All Patient Refined DRGs (APR), Present on Admission (POA), as ... of Diseases, Clinical Modification (ICD-CM) diagnosis and procedure codes, MS- DRG , APR DRG , POA, SOI & ROM...(RHIT), Registered Health Information Administrator (RHIA), or Certified Coding Specialist (CCS) is required. Page 3 3. Three (3)… more
- Highmark Health (Helena, MT)
- …II code and modifier assignments, ICD diagnosis and procedure coding, DRG /APC structure according to regulatory requirements. Reports findings both verbally and ... systems, missed secondary diagnoses and procedures and ensures compliance with DRG /APC structure and regulatory requirements. Performs periodic claim form reviews to… more
- Trinity Health (Livonia, MI)
- …within their region. Provides direct oversight of the Clinical Documentation Specialist and Clinical Documentation Integrity Coordinator. Working with the Regional ... directly responsible for the daily assessments of current Clinical Documentation Specialist staffing levels and processes. Ensures that defined goals are… more
- Texas Health Resources (Arlington, TX)
- …. Ability to apply definition of principal diagnosis for accurate coding, MS- DRG and POA assignment. . Strong knowledge of ICD-10-CM/PCS diagnosis and procedure ... coding guideline, DRG and POA assignment. . Moderate skills including MS...coding and compliance purposes. . Collaborates with Clinical Documentation Specialist to improve coding and documentation. . Demonstrates and… more
- Penn Medicine (Lititz, PA)
- …analysis and provider profiling. Review coded medical records for coding and DRG accuracy by verifying that the principal diagnosis, secondary diagnoses, principal ... + Identify and communicate documentation issues and concerns that influence coding, DRG assignment, and severity of illness assessment to management as identified. +… more