- Elevance Health (Tampa, FL)
- ** Manager DRG Coding Validation ( Manager Program and Project Management)** **** **Hybrid 2:** This role requires associates to be in-office **3** ... eliminate and prevent unnecessary medical-expense spending. The Manager of DRG Coding Audit & Clinical Validation leads a high-performing team… more
- Zelis (St. Petersburg, FL)
- …you've gained, and the personal interests that shape who you are. Position Overview The Manager , DRG Validation of the Expert Claims Review (ECR) department ... team management of the DRG product. The Manager , DRG Validation will be...primarily responsible for the oversight of DRG validation reviews to ensure accurate and compliant coding… more
- Elevance Health (FL)
- … 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
- AdventHealth (Maitland, 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
- HCA Healthcare (Tampa, FL)
- … 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
- Molina Healthcare (Tampa, FL)
- …reports quality of care issues. + Assists with Complex Claim review including DRG Validation , Itemized Bill Review, Appropriate Level of Care, Inpatient ... for a RN with experience with appeals, claims review, and medical coding . **Job Summary** Utilizing clinical knowledge and experience, responsible for review of… more