- Elevance Health (Chicago, IL)
- ** DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ __ This role enables associates to work virtually full-time, with the exception of required in-person ... determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** DRG CODING AUDITOR ** is responsible for auditing inpatient medical… more
- Elevance Health (Chicago, IL)
- … Credential such as CCS or CIC. + Experience with third party DRG Coding and/or Clinical Validation Audits or hospital clinical documentation improvement ... **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
- Highmark Health (Springfield, IL)
- …HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding , DRG /APC structure according to regulatory requirements. Reports findings both ... Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or physician...In-depth knowledge of ICD CM, ICD PCS and CPT/HCPCS coding systems. Must be proficient in DRG /APC… more
- R1 RCM (Chicago, IL)
- …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our DRGV Auditor II, your primary role will be auditing inpatient cases for ... DRG validation and/or documentation improvement. This consists of reviewing...accounts. Opportunity for growth includes a client facing Lead Auditor role and an internally facing Mentor role. **Every… more
- Datavant (Springfield, IL)
- …coding experience with ICD-10-CM/PCS and MS-DRGs. + Minimum 1-2 years in a coding lead, auditor , or supervisory role. + Associate's degree in Health ... priorities. + Team-oriented with strong problem-solving skills. + Expert knowledge of coding guidelines, DRG assignment, and reimbursement methodology. + Strong… more
- Datavant (Springfield, IL)
- …Level Agreements or Other Types of reviews, using appropriate assignment of codes and other coding -related elements using MS DRG or APR DRGs. + Provides rich and ... will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education,… more