- Excellus BlueCross BlueShield (Rochester, NY)
- Job Description: Summary: The Payment Integrity DRG Coding & Clinical Validation Analyst position has an extensive background in acute facility-based clinical ... documentation, and/or inpatient coding and has a high level of understanding of the current MS- DRG , and APR- DRG payment systems. This position is responsible… more
- Insight Global (South Jordan, UT)
- …knowledge ( DRG & ICD-10) Registered Nurse RN (must be inpatient ) WITH coding/clinical documentation certification (2 years in clinical documentation) OR IF ... Job Description Insight Global is seeking a DRG Validation Auditor for one of our clients...extensive background in either facility-based nursing, clinical documentation, and/or inpatient coding and has a high level of understanding… more
- Elevance Health (Hanover, MD)
- …is determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** DRG CODING AUDITOR** is responsible for auditing inpatient medical ... and other documentation to evaluate issues of coding and DRG assignment accuracy. Specializes in review of...where additional recoveries may be available, such as re-admissions, Inpatient to Outpatient, and HACs. + Suggests and develops… more
- Hartford HealthCare (Farmington, CT)
- …is responsible for reviewing, analyzing and appealing denials related to DRG (Diagnostic Related Group) downgrades. This role involves validating the coding ... address payer concerns. Key responsibilities include timely investigation of DRG downgrades, submitting appeals, coordinating follow-up actions and ensuring… more
- HCA Healthcare (Nashville, TN)
- …personal growth, we encourage you to apply for our Coding Quality Audit Reviewer opening. We promptly review all applications. Highly qualified candidates will ... We care like family! Jump-start your career as a DRG Validation Auditor today with Parallon. **Benefits** Parallon offers...Come join our team as a Coding Quality Audit Reviewer . We care for our community! Just last year,… more
- WMCHealth (Valhalla, NY)
- …in working with multiple computer applications and EMR systems. Responsibilities: + Review diagnostic, procedural and DRG assignments for validity and accuracy. ... DRG Validator Company: NorthEast Provider Solutions Inc. City/State:...have a minimum of 5 years' experience specializing in inpatient . Education: Bachelor's degree in a health related field,… more
- UTMB Health (Galveston, TX)
- …**Minimum Qualifications** High school or equivalent and three years of experience. The Sr. DRG coder must be proficient in inpatient coding with the ability to ... coding of all pertinent diagnoses and procedures and to provide optimal DRG assignment after thorough review of medical record and analysis of DRG options.… more
- Insight Global (Plano, TX)
- …The DRG Revenue Integrity Auditor will perform Diagnostic Related Group ( DRG ) validation and quality audits on inpatient charts to ensure accurate ... Job Description Insight Global is seeking experienced DRG Auditors to join a remote healthcare organization.… more
- Houston Methodist (Houston, TX)
- …(includes CPT) (for inpatient /outpatient coding) coding classification systems + For inpatient /outpatient coding: MS- DRG , APR DRG and APC assignment ... education **WORK EXPERIENCE** + Eight years of progressive coding and/or coding review (auditing) experience at a large facility or multi-facility + Some… more
- Hartford HealthCare (Farmington, CT)
- …and other common practices across the system. *_Position Summary:_* Reviews inpatient clinical documentation to determine the appropriate assignment of alpha numeric ... diagnosis/procedure codes and Medicare Severity Diagnosis Related Groups (MS- DRG ). Data is classified for internal and external statistical reporting, research,… more