- Molina Healthcare (Columbus, OH)
- **Job Description** **Job Summary** The Manager , Clinical DRG Coding & Validation must have an extensive background in either facility-based nursing ... Key participant in the development and implementation of the DRG validation program. Responsible for auditing inpatient...medical records and other documentation to evaluate issues of coding and DRG assignment accuracy. Ensures that… more
- Elevance Health (Norfolk, VA)
- …Skills, Capabilities and Experiences** : + BA/BS preferred. + Experience with vendor based DRG Coding / Clinical Validation Audit setting or hospital ... ** DRG Coding Auditor Principal** _Virtual: This...billing/payment systems provider billing guidelines, payer reimbursement policies, billing validation criteria and coding terminology strongly preferred… more
- Elevance Health (Chicago, IL)
- …Skills, Capabilities and Experiences** : + BA/BS preferred. + Experience with vendor based DRG Coding / Clinical Validation Audit setting or hospital ... ** DRG CODING AUDITOR** **Location** : _This...billing/payment systems provider billing guidelines, payer reimbursement policies, billing validation criteria and coding terminology preferred. +… more
- Elevance Health (Chicago, IL)
- … 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** **Virtual:** This role enables associates to...and reimbursed. Specializes in review of Diagnosis Related Group ( DRG ) paid claims. **How you will make an impact:**… more
- PeaceHealth (Vancouver, WA)
- … product. + May manage the denials/appeals process for coding and clinical validation related to DRG downgrades. + Performs other duties as assigned. **What ... **Description** **PeaceHealth is seeking a Manager of Hospital Coding - Hospital... coding using the ICD-10-CM and CPT4/HCPCS classification coding systems. Familiar with MS- DRG , APR- DRG… more
- HCA Healthcare (Nashville, TN)
- … Coding Manager in verifying and reporting staff productivity for Coding , DRG /Code Validation , Unbilled, CDI reconciliation and CARS functions ... Lead, you will perform as the daily contact for coding , DRG /code validation , operational, and...(CARS), and/or CDI Liaisons with day-to-day operations + Assists Coding Manager in the review and improvement… 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 ... work location** **POSITION PURPOSE** At the direction of the Regional Manager , Clinical Documentation Integrity (CDI), this position supervises daily operations of… 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
- Molina Healthcare (WI)
- …reports quality of care issues. + Assists with Complex Claim review including DRG Validation , Itemized Bill Review, Appropriate Level of Care, Inpatient ... appropriate level of care utilizing MCG/InterQual, state/federal guidelines, billing and coding regulations, and Molina policies; validates the medical record and… more