- CoxHealth (Lake Spring, MO)
- …closely with the CDI Manager, CDI Supervisor, CDI Team Lead, CDI Specialists, Medical Director- Coding /CDI, Inpatient Coding Supervisor and Team Leaders of ... and provides requested feedback for the following Committees: 1) Coding and Documentation Committee 2) Utilization Review ...5) Other Educational meetings as assigned by CDI Manager, Medical Director, Coding /CDI and System Director, … more
- Stanford Health Care (Palo Alto, CA)
- …**Locations** Stanford Health Care **What you will do** + Adheres to the defined review timeline and coding review protocol standards; assists with ... General) compliance standards. Applies standardized scoring methodology to consistently evaluate coding accuracy and standardizes review findings and methodology… more
- Memorial Sloan-Kettering Cancer Center (New York, NY)
- …special project reviews requiring advanced CDI and coding knowledge + Audit medical records to ensure accurate DRG optimization, severity of illness, and ... certifications (CCS, CCDS, RHIA, RHIT) highly valued - Experience with ICD-10-CM/PCS coding / DRG assignment preferred + Strong collaboration, communication, and… more
- Stanford Health Care (Palo Alto, CA)
- …work groups to successful outcomes. + Knowledge of medical and insurance terminology, MS- DRG , APR- DRG , CPT, ICD coding structures, and billing forms (UB, ... Conduct thorough analyses of denials, evaluating the appropriateness of medical services and procedures. Ensure accurate coding ...and comprehensive appeal letters to payors after a detailed review of medical records. Ensure compliance with… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …compliance with contractual, coding , payment policy, and regulatory standards. + Review itemized bills, medical records, and other claim documentation to ... Investigation Unit and Payment Integrity Specialists. This role requires medical coding experience and solid written and...Abilities** + Basic understanding of CPT, HCPCS, ICD-10-CM, and DRG coding . + Strong attention to detail… more
- Centene Corporation (Helena, MT)
- …CANDIDATE WILL HAVE DRG CODING EXPERIENCE **Position Purpose:** Perform clinical/ coding medical claim review to ensure compliance with coding ... flexibility. POSITION IS REMOTE CANDIDATE WILL REVIEW INPATIENT DRG 'S IDEAL...directives, precedent, AMA and CMS code edit criterion + Review medical records to ensure billing is… more
- UPMC (Pittsburgh, PA)
- …were performed during an episode of care. + Review and evaluate focused UPMC DRG medical records for accurate DRG assignment to ensure that all ... hours Monday through Friday. In this role, you will review clinical documentation within the medical record... selection; OR specific knowledge as a consultant in Medical Record coding and DRG … more
- Elevance Health (Hanover, MD)
- …of coding and DRG assignment accuracy. Specializes in review of DRG coding via medical record and attending physician's statement sent in by ... Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The ** DRG CODING ...eliminate and prevent unnecessary medical -expense spending. The ** DRG CODING AUDITOR** is responsible for auditing… more
- Penn Medicine (Philadelphia, PA)
- …Rd 4th Floor Bala Cynwyd Hours: M-F, 8a-430p or similar Review coded medical records for coding and DRG and/or Evaluation and Management accuracy ... the following, but not limited to, areas: subject focused, purely randomized, CPT-4 Coding , Systemic Monitoring and Review Technology (SMART) audits on 100%… more
- Zelis (FL)
- …policy exclusions. Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10 Official Coding Guidelines, AHA Coding Clinic and ... that shape who you are. Position Overview The Inpatient DRG Reviewer will be primarily responsible for...and billing rules + Clinical skills to evaluate appropriate Medical Record Coding + Experience conducting root… more
