- Community Health Systems (Franklin, TN)
- **Job Summary** The DRG Denials Auditor conducts hospital inpatient DRG denial audits for both RAC and non-RAC accounts, reviewing patient records for ... accuracy in ICD-10-CM/PCS coding, DRG assignments, and supporting clinical documentation. This includes evaluating...any other relevant data to ensure coding accuracy. The auditor is also responsible for writing and defending appeal… more
- Catholic Health (Buffalo, NY)
- …based on role of management and oversight of team Summary: The Clinical Denials and Appeals, Clinical Supervisor is responsible for the people, carrying out and ... but not limited to clinical documentation/support for diagnostic related grouping ( DRG ) assignment, inpatient and outpatient medical necessity. The individual also… more
- Sharp HealthCare (San Diego, CA)
- …*This is a remote position* **What You Will Do** The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's (SHC's) compliance ... coding or professional E/M coding in the following coding systems: ICD-10-CM/PCS, DRG , CPT& HCPCs, and/or E/M CPT. **Preferred Qualifications** + Other : Strong… more
- AdventHealth (Tampa, FL)
- …and allied health personnel. Assists with writing compelling appeals to all DRG denials from outside agencies, referencing Official Coding Guidelines and ... Performs quality reviews on coded records to validate ICD-10, ICD-10-PCS, MS- DRG , APR-DRGs, and overall coding accuracy retrospectively and concurrently. Provides… more
- St. Luke's University Health Network (Allentown, PA)
- …medical record reviews for clinical validation of diagnosis and procedure code assignment and MS- DRG /APR- DRG accuracy based on denials or audit findings from ... all diagnosis and procedure codes to assure properly assigned MS- DRG or APR- DRG for the purpose of...made by the government or commercial payors, or their auditor representative. + Facilitate clinical chart reviews to assist… more
- Texas Health Resources (Arlington, TX)
- …management correction plans when necessary. Additionally, the Compliance Auditor Manager effectively communicates audit findings through reports, presentations, ... additional reviews to assist departments handling Medicare, OIG, or non-Medicare denials . Provide expert analysis on coding, documentation, and applicable regulatory… more