- Elevance Health (Denver, CO)
- … Coding Credential such as CCS or CIC. + Experience with third party DRG Coding and/or Clinical Validation Audits or hospital clinical documentation ... **Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS- DRG , AP- DRG...+ Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance… more
- Elevance Health (Tampa, FL)
- …Skills, Capabilities and Experiences** : + BA/BS preferred. + Experience with vendor based DRG Coding / Clinical Validation Audit setting or hospital ... ** DRG CODING AUDITOR** **_Virtual_** **_: _**...billing/payment systems provider billing guidelines, payer reimbursement policies, billing validation criteria and coding terminology preferred. +… more
- Hartford HealthCare (Farmington, CT)
- …. Provide ongoing education to the coding and CDI teams regarding DRG validation , payer guidelines, and best practices to minimize future denials. . ... guidelines. *_Working Relationship:_* *This Job Reports To (Job Title):*HIM Manager Coding Quality and Education *Education* ....assignment, and payer regulations related to DRG validation . . Ability to analyze medical records, coding… more
- Marshfield Clinic (Marshfield, WI)
- …concerns and DRG assignments + Assists in the preparation of responses to DRG validation requests and other third party payer inquiries related to coding ... the most exciting missions in the world!** **Job Title:** Hospital Coding Specialist III (Remote) **Cost Center:** 101651098 System Support-Facility Coding… more
- AdventHealth (Orlando, FL)
- … coding and reimbursement system and any weakness identified during the coding validation reviews. Qualifications **The expertise and experiences you'll need ... each year **The role you'll contribute:** Under the general supervision of the Coding Quality Manager , the Data Quality Reviewer is responsible for validating… more
- Trinity Health (Livonia, MI)
- …or enterprise level desirable. Must have thorough knowledge of CMS regulations, coding guidelines and DRG reimbursement. Project management and/or system ... and education to clinical documentation specialists (CDS) to enhance clinical and coding skill sets and optimal utilization of 3M CDI software. Analyzes data… more
- Trinity Health (Livonia, MI)
- …integrity program is required. Must have thorough knowledge of CMS regulations, coding guidelines and DRG reimbursement. Demonstrated knowledge of state and ... PURPOSE** Work Remote Position At the direction of the Regional Manager , Clinical Documentation Integrity (CDI), this position supervises daily operations of… more
- HCA Healthcare (Fredericksburg, VA)
- … Coding Manager in verifying and reporting staff productivity for Coding , DRG /Code Validation , Unbilled, CDI reconciliation and CARS functions **What ... identified trends, RAC, payer, etc.) for inpatient and/or outpatient coding (eg, DRG /code validation , query...(CARS), and/or CDI Liaisons with day-to-day operations + Assists Coding Manager in the review and improvement… more
- Stanford Health Care (Palo Alto, CA)
- …work groups to successful outcomes. + Knowledge of medical and insurance terminology, MS- DRG , APR- DRG , CPT, ICD coding structures, and billing forms ... ICD, HCPCS, CPT codes, as well as APC and DRG assignments, while identifying instances of overpayments and underpayments....(UB, 1500). + Experience with coding , clinical validation , and medical necessity for… more
- Covenant Health Inc. (Knoxville, TN)
- …related to initial DRGs and updates to working DRGs and SOI/ROM for final coding and DRG assignment. + Prepares reports for any assigned facilities. Assists ... of documentation, and the appropriate assignment of a final DRG . The CDI Specialist functions as a resource for...federal regulations to ensure compliance. + Keeps current on coding guidelines and communicates to Health Information Manager… more