- Zelis (St. Petersburg, FL)
- …you've gained, and the personal interests that shape who you are. Position Overview The Manager , DRG Validation of the Expert Claims Review (ECR) department ... for daily operations and team management of the DRG product. The Manager , DRG Validation will be primarily responsible for the oversight of DRG… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The purpose of DRG validation is to confirm that diagnostic, procedural information, and the discharge status of the beneficiary, as coded ... CRM works in conjunction with the Associate Director and Director of DRG Validation to help develop coding education and training and institutional coding… more
- Elevance Health (Hanover, MD)
- **Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS- DRG , AP- DRG and APR- DRG )** **Virtual:** This role enables associates to work virtually ... as CCS or CIC. + Experience with third party DRG Coding and/or Clinical Validation Audits or...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Elevance Health (Richmond, VA)
- …Skills, Capabilities and Experiences** : + BA/BS preferred. + Experience with vendor based DRG Coding / Clinical Validation Audit setting or hospital coding or ... ** DRG CODING AUDITOR** **_Virtual_** **_: _** _ _...billing/payment systems provider billing guidelines, payer reimbursement policies, billing validation criteria and coding terminology preferred. + Knowledge of… more
- Hartford HealthCare (Farmington, CT)
- …*_Position Responsibilities:_* *Key Areas of Responsibility* *Denial Resolution* . Review DRG validation denials from payers, analyze the denial reasons, ... *Education* . Provide ongoing education to the coding and CDI teams regarding DRG validation , payer guidelines, and best practices to minimize future denials.… more
- Marshfield Clinic (Marshfield, WI)
- …concerns and DRG assignments + Assists in the preparation of responses to DRG validation requests and other third party payer inquiries related to coding and ... for Coding and Reporting. The Hospital Coding Specialist II provides charge validation and capture processes for various patient types. This individual assigns codes… more
- Marshfield Clinic (Marshfield, WI)
- …concerns and DRG assignments + Assists in the preparation of responses to DRG validation requests and other third party payer inquiries related to coding and ... Uniform Hospital Discharge Data Set (UHDDS) and assignment of the appropriate MS- DRG (Medicare Severity-Diagnosis Related Group) or APR- DRG (All Patients Refined… more
- Trinity Health (Livonia, MI)
- …PURPOSE** Work Remote Position At the direction of the Regional Manager , Clinical Documentation Integrity (CDI), this position supervises daily operations of ... and Clinical Documentation Integrity Coordinator. Working with the Regional Manager , Clinical Documentation Integrity, is directly responsible for the daily… more
- HCA Healthcare (Tampa, FL)
- …needs, identified trends, RAC, payer, etc.) for inpatient and/or outpatient coding (eg, DRG /code validation , query validation ) + Provides timely feedback and ... and/or CDI Liaisons with day-to-day operations + Assists Coding Manager in the review and improvement of processes and... in verifying and reporting staff productivity for Coding, DRG /Code Validation , Unbilled, CDI reconciliation and CARS… more
- Covenant Health Inc. (Knoxville, TN)
- …records, the accuracy of documentation, and the appropriate assignment of a final DRG . The CDI Specialist functions as a resource for clinical staff and other ... discharge planning of patients. In order to assure appropriate DRG assignment and the validity and reliability of the...in the diagnosis and treatment of the patient. The validation of the clinical diagnoses is an additional focus… more