- Elevance Health (Louisville, KY)
- ** 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
- Elevance Health (Louisville, KY)
- … 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 (Louisville, KY)
- …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
- Molina Healthcare (Lexington, KY)
- …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