- Penn Medicine (Lititz, PA)
- …compliance with regulations, and accuracy for clinical care analysis and provider profiling. Review coded medical records for coding and DRG accuracy by ... + Position Summary: : Codes and abstracts information from inpatient and outpatient records by careful analysis and adherence...cross training to existing staff as needed. + Research, review and respond to coding and coding quality issues… more
- Molina Healthcare (Warren, MI)
- …Complex Claim review including DRG Validation, Itemized Bill Review , Appropriate Level of Care, Inpatient Readmission, and any opportunity identified ... set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing clinical knowledge and experience,… 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 ... Sequences the diagnoses & procedures to obtain the optimal DRG or APR- DRG assignment and demonstrates 95%...the following guidelines: + HUP - Average of 7.5-11.5 inpatient records coded daily + PPMC - Average of… more
- University of Utah Health (Salt Lake City, UT)
- …Provider card. + Proficiency in application of InterQual Criteria, knowledge of ICD-9, DRG 's and CPT Codes. + Utilization Review Certification designation. + ... appropriateness of admissions with associated levels of care and continued stay review . + Communication to third-party payers for initial and concurrent clinical … more
- HonorHealth (AZ)
- …Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization of health care services ... high quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and … more
- HonorHealth (AZ)
- …it does. Learn more at HonorHealth.com. Responsibilities Job SummaryThe Utilization Review RN Specialist reviews and monitors utilization of health care services ... high quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and … more
- UTMB Health (Galveston, TX)
- …of patient status that translates into coded data. **Job Duties:** + Concurrently review inpatient admissions to identify opportunities to clarify missing or ... inpatient ICD-10 coding guidelines and clinical documentation requirements to assign working MS- DRG . + Enter review information and working MS- DRG /APR-… more
- Geisinger (Danville, PA)
- …The core of the program uses highly trained staff members to perform a concurrent inpatient review of the record. This allows the record to be coded post ... experience is required. BSN is strongly preferred. Job Duties: + Reviews inpatient medical records within 24-48 hours of admission for a specified patient… more
- Penn Medicine (Philadelphia, PA)
- …are charted appropriately within defined regulatory timeframes + Assign a working MS- DRG upon initial admission review , and communicate with Physician or ... to reflect truth in diagnostic reflection. Responsibilities: + Direct review of patient charts to audit clarity and full...abstraction of clinical indicators, and the assignment of Initial DRG and Working DRG + Generate compliant… more
- Pine Rest Christian Mental Health Services (Grand Rapids, MI)
- …center and a soon-to-be-built pediatric behavioral health center, outpatient, inpatient , partial hospitalization (day programs), assessment and testing, residential, ... You'll be responsible for the timely and accurate coding review of all HRS and ORS records for the...Accurately applies professional and facilities coding principles to HRS inpatient , Partial, PUCC, Residential, and ORS clinic encounters. +… more