direction of the DRG Operations Department leaders, the DRG Reviewer will conduct reviews of inpatient claims for both coding.... As such, we are a leading authority in payment integrity solutions including DRG Validation, Cost Outlier and Readmission reviews. Under the...
balance, continuous learning, and career development. Summary We are seeking a talented individual for a DRG Nurse... Reviewer Appeals and Hearings to coordinate and perform all appeal related duties including analyzing and responding...
balance, continuous learning, and career development. Summary We are seeking a talented individual for a DRG Nurse... Reviewer Appeals and Hearings to coordinate and perform all appeal related duties including analyzing and responding...
reviews of MS-DRG and APR-DRG coding and clinical documentation to ensure the accuracy of DRG assignment and reimbursement... errors or upcoding. Operates with significant autonomy in supporting DRG validation reviews and appeals, interpreting...
Fantastic North Little Rock Opportunity for an Experienced LPN Clinical Reviewer. Reviewer is responsible for the pre... and claims review including but not limited to the following claims: NDC number repricing DRG Case Rates Stop Loss High...
Title: Clinical Reviewer RN Location: Remote (must hold an unrestricted Massachusetts RN license) Duration: 5-month... is not required. Overview: We are seeking an experienced Inpatient RN Utilization Reviewer to independently manage a clinically complex...
, please review this . The Clinical Documentation Integrity (CDI) Second Level Reviewer performs high-level, complex, secondary case... for CDI/Coding/Quality. The CDI Second Level Reviewer works in collaboration with CDI & quality leadership, CDI specialists...
Duration: 4 months contract (with possible extension) Job Description: The Clinical Reviewer, Inpatient RN..., and others. The Clinical Reviewer, Inpatient RN is responsible for making the determination of medical necessity and, therefore...
associated Diagnosis Related Group (DRG) assignments, case-mix index, severity of illness (SOI), and risk of mortality (ROM... and completeness of supporting documentation to determine a working and final DRG, SOI, and/or ROM. Job Responsibilities...
, medical STAFFnd various hospital departments. The reviewer also codes and abstracts inpatient, ambulatory and observation... • RHIA, RHIT, or CCS preferred • Minimum of 3 years of DRG-based coding experience in an acute care hospital with experience...
-level reviewer through the review of medical records of patients identified by care managers or as requested by the... of mortality, and DRG assignments on their individual patient records. Works with the EHR team and quality officers...
as second-level reviewer through the review of medical records of patients identified by care managers or as requested by the... of mortality, and DRG assignments on their individual patient records. Works with the EHR team and quality officers...
, which will provide an accurate MS-DRG or APR-DRG for appropriate reimbursement. Ensures all accounts are coded within 4 days of the... to the appropriate patient's encounter. While reviewing the record for coding purposes, serves as a quality reviewer...
for the medical staff regarding federal and state utilization and quality regulations. Acts as second-level reviewer through.... inpatient) and clinical terminology to improve their understanding of severity, acuity, risk of mortality, and DRG assignments...
-level reviewer through the review of medical records of patients identified by care managers or as requested by the..., risk of mortality, and DRG assignments on their individual patient records. Works with the EHR team and quality officers...
-level reviewer through the review of medical records of patients identified by care managers or as requested by the.... inpatient) and clinical terminology to improve their understanding of severity, acuity, risk of mortality, and DRG assignments...