• DRG Specialist

    UPMC (Pittsburgh, PA)
    UPMC Corporate Revenue Cycle is hiring a DRG Specialist to work on inpatient auditing within our Coding Department. This position will be a work-from-home ... necessary in coordination with the Coding Manager and/or Coding Specialist and assist in correcting deficiencies in DRG... Specialist and assist in correcting deficiencies in DRG assignment. + Prepare monthly productivity reports of … more
    UPMC (06/11/25)
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  • Coder II - Technical

    UPMC (Pittsburgh, PA)
    …documentation and/or clarification to accurately complete the coding process. Consult with DRG Specialist when applicable during query process. + High School ... sequenced in order of their clinical significance to accurately assign the appropriate DRG /APC/ASC or payment tier under the Prospective Payment system or DSM IV… more
    UPMC (07/27/25)
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  • Facility Coding Inpatient DRG Quality

    Banner Health (PA)
    …quality in the Inpatient Facility Coding department. If you have experience with DRG and PCS coding/denials/audits, we want to hear from you. **Requirements:** + **5 ... facility-based medical coding (clearly reflected in your attached resume);** + ** DRG and PCS Coding, Auditing experience;** + **Bachelors degree or equivalent;**… more
    Banner Health (06/15/25)
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  • Coding Appeals Specialist

    St. Luke's University Health Network (Allentown, PA)
    …of a patient's ability to pay for health care. The Coding Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all diagnosis ... and procedure codes to assure properly assigned MS- DRG for the purposes of appealing proposed MS-...assigned to support the services/treatment rendered. The Coding Appeals Specialist also prepares appeal arguments and/or letters to support… more
    St. Luke's University Health Network (05/19/25)
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  • RN Clinical Review Appeals Specialist

    St. Luke's University Health Network (Allentown, PA)
    …patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all ... diagnosis and procedure codes to assure properly assigned MS- DRG or APR- DRG for the purpose of appealing proposed DRG and coding changes by insurance… more
    St. Luke's University Health Network (07/08/25)
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  • Coding Appeals Specialist

    St. Luke's University Health Network (Allentown, PA)
    …regardless of a patient's ability to pay for health care. The Coding Appeals Specialist analyzes patient medical records, claims data and coding on all diagnosis and ... procedure codes to assure properly assigned MS- DRG for the purposes of appealing proposed MS- DRG and coding changes by insurance providers or their auditors.… more
    St. Luke's University Health Network (07/08/25)
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  • Outpatient Coding Specialist

    St. Luke's University Health Network (Allentown, PA)
    …of a patient's ability to pay for health care. The Coding Specialist codes and abstracts all pertinent patient medical information according to ICD-10-CM/PCS ... the 3M Encoder to verify and assign ICD-10-CM/PCS and CPT-4 codes, and MS- DRG /APR- DRG assignment + Maintains 95% data quality coding accuracy rate as measured… more
    St. Luke's University Health Network (07/18/25)
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  • RN - Registered Nurse Clinical Documentation…

    Geisinger (Danville, PA)
    …subsequent review of records every three days to support and assign a working DRG assignment upon discharge. + Formulates queries when it is determined there is ... procedures and completeness of supporting documentation to determine the working and final DRG , severity of illness and risk of mortality. + Acts as a resource… more
    Geisinger (06/11/25)
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  • Coding Audit Training Specialist

    Intermountain Health (Harrisburg, PA)
    …risk of mortality, and quality of care + Performs audits including DRG (Diagnosis Related Groups), ICD-10 CM/PCS (Procedure Classification System), CPT, and PSI ... of medical terminology, medical acronyms, pharmacology, anatomy and physiology and ICD-10-CM/PCS, DRG , and APR- DRG classification systems. + Ability to complete… more
    Intermountain Health (07/29/25)
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  • Inpatient Audit Specialist

    Datavant (Harrisburg, PA)
    …vision for healthcare. **What We're Looking For:** As an Inpatient Auditing Specialist , you will be instrumental in addressing consulting and educational needs ... assignment of codes and other coding-related elements using MS DRG or APR DRGs. + Provides rich and concise...CCS (required), RHIA or RHIT preferred + Maintain 95% DRG accuracy rate + Experience with various software including… more
    Datavant (07/29/25)
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