- Kaleida Health (Buffalo, NY)
- ** Director Clinical and DRG Denials ** **Location:** Larkin Bldg @ Exchange Street Location of Job: US:NY:Buffalo Work Type: Full-Time **Shift:** Shift 1 ... Job Description **Summary:** The Director , Clinical & DRG Denials provides clinical leadership and administrative guidance to the Clinical … more
- 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...denial and appeal status. + Consults with Coordinator and/or Director , Coding Denials and Appeals during any… more
- Rochester Regional Health (Rochester, NY)
- Job Title: Director , CDI Department: Clinical Documentation ImprovementLocation: Riedman CampusHours Per Week: 40Schedule: Monday - Friday, 8am - 4:30pmSUMMARY ... The Clinical Documentation Improvement Director provides a key...system committees and work groups, including billing, revenue cycle, denials , and others as assigned. + Ensure effective staffing… more
- St. Luke's University Health Network (Allentown, PA)
- …reviews for clinical validation of diagnosis and procedure code assignment and MS- DRG /APR- DRG accuracy based on denials or audit findings from government ... patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records,...all diagnosis and procedure codes to assure properly assigned MS- DRG or APR- DRG for the purpose of… more
- Beth Israel Lahey Health (Charlestown, MA)
- …and compliance issues to Revenue Cycle Leadership. * Perform process review of denials by hospital departments, and provide clinical improvement initiatives. * ... Minimum of two (2) to three (3) years auditing and familiarity with CPT/HCPCs/ DRG coding experience required. * Clinical education and/or utilization review… more
- Trinity Health (Livonia, MI)
- …and Local Health Physician Champions, Chief Medical Officers, HM Executive Leadership, clinical staff, coding and denials teams to facilitate documentation ... and day-to-day management of the CDI programs. Works with Director , CDI to ensure the program is in alignment...supports the patient's severity of illness, risk of mortality, clinical validity and proper DRG assignment. **ESSENTIAL… more
- Covenant Health Inc. (Knoxville, TN)
- …Working directly with the physicians, Manager of Corporate Coding Services, Director of Registration/Admitting, and medical staff education efforts, serves as the ... user advocate between Health Information Management (HIM), Clinical Effectiveness, and Registration. Other job duties include: improving health record documentation… more
- CommonSpirit Health (Englewood, CO)
- …by Utilization Management or Managed Care: Works with the Care Management Director and staff to facilitate client profiles, clinical service utilization ... We are seeking a highly skilled individual to develop and submit clinical appeals, expertly crafting physician-aligned letters based on federal and state… more
- AdventHealth (Tampa, FL)
- …Research Institute, also located at AdventHealth Tampa, leads the way in clinical and academic research in the areas of neuroscience, cardiovascular medicine, ... and other diseases. **The ro** **le you'll contribute:** Oversees site-based Clinical Documentation Integrity (CDI) program; monitors and maintains the timeliness of… more
- AdventHealth (Orlando, FL)
- …Assist in billing for technical component of services and appeals for denials . Provides guidance to clinical questions from Utilization Management staff ... work life balance **PRINCIPAL DUTIES AND JOB RESPONSIBILITIES** **:** Provides clinical support/validation for Care Management, CDI and Quality teams. Provides… more
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