- Community Health Systems (Franklin, TN)
- **Job Summary** The DRG Denials Auditor conducts hospital inpatient DRG denial audits for both RAC and non-RAC accounts, reviewing patient records for accuracy in ... to improve coding practices and compliance. **Essential Functions** + Performs inpatient denial reviews using ICD-10-CM/PCS and DRG validation utilizing appropriate… more
- Community Health Systems (Fort Wayne, IN)
- …Specialist Lead provides advanced support for CDI activities within the facility , ensuring the accuracy, completeness, and integrity of clinical documentation to ... support appropriate coding, reimbursement, and quality outcomes. This role leads facility -level CDI efforts, supports education and mentoring of CDI team members,… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …will develop and execute audit, monitoring, and education for both facility and professional billing, coding and documentation programs that ensure compliance ... with regulatory standards. Continuously evaluate facility /professional billing compliance activities to assess compliance with the Compliance Audit and Analysis… more
- Amergis (Independence, OH)
- …and school-based professionals, ready towork in any hospital, government facility , or school. Through partnership andinnovation, Amergis creates unmatched staffing ... Remote Coding Manager serves as a liaison to the facility (s) HIM staff in resolving identified problems/issues. Essential Duties...at each site managed. Audits 100% of all new coder 's work on a pre-bill basis. Sends audit results… more
- Molina Healthcare (Albuquerque, NM)
- …member care. For this position we are seeking an RN with previous Inpatient Hospital, Skilled Nursing Facility experience, and outpatient coding experience ... group (DRG) validation, itemized bill review, appropriate level of care, inpatient readmission, and any opportunity identified by the payment Integrity analytical… more
- UPMC (Pittsburgh, PA)
- UPMC Corporate Revenue Cycle is hiring a DRG Specialist to work on inpatient auditing within our Coding Department. This position will be a work-from-home position ... Clearances:** + Certified Coding Specialist (CCS) OR Certified Professional Coder (CPC) OR Certified Registered Nurse Practitioner OR Doctor...34 *Current licensure either in the state where the facility is located or, if the facility … more
- Kaleida Health (Buffalo, NY)
- …is responsible for coding, including, but not limited to any type of inpatient /or outpatient medical records for the purpose of data quality, accurate reimbursement, ... in the medical record. This position is responsible to calculate the facility E/M level using designated software application and performs charge posting for… more
- Organon & Co. (Plymouth Meeting, PA)
- …in the future. The ideal candidate will possess deep expertise in facility and healthcare provider reimbursements by payer type, including commercial, Medicare, and ... physician billing. + **Reimbursement Expertise:** Serve as an expert in facility and healthcare provider reimbursements by payer type, including commercial,… more
- Houston Methodist (Katy, TX)
- …N/A **LICENSES AND CERTIFICATIONS - PREFERRED** + CPC - Certified Professional Coder (AAPC) -- or equivalent if overseeing revenue integrity related functions ... + Familiarity with managed care terminology and payor adjudication such as Inpatient / Outpatient Prospective Payment Systems, etc. + Stays informed of the latest… more
- Stony Brook University (Commack, NY)
- …education training for new employees. + Assess and provide feedback to each coder on their work performed. + Development of reinforcement training for existing staff ... + Provide education to the CDI staff on the Inpatient Prospective Payment System. + Provide education to the...Stony Brook Medicine, Stony Brook University Hospital and related facilities . **Prior to start date, the selected candidate must… more
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