Analyst will conduct clinical audits including, but not limited to, Diagnosis Related Grouper Validation (DRG), medical record... billing discrepancies, and prior authorization discrepancies per policies. The DRG Analyst is responsible for verifying the...
Validation Specialist (aka Clinical Bill Review Analyst, DRG) will conduct clinical audits including, but not limited... per policies. The DRG Analyst is responsible for verifying the accuracy of DRG claims submitted for review by selecting claims...
are set at a DRG accuracy rate of 95% or higher among other quality measures. Meeting Accounts Receivable goals supports... classification systems. Completes MS-DRG and APR-DRG assignments on inpatient records as appropriate. Ensures ethical and accurate...