- Rochester Regional Health (Rochester, NY)
- …third level appeals. Appeals are submitted timely and tracked through final outcome. The Clinical DRG Denials Specialist will also handle audit-related ... based on documented clinical indicators. Collaborates closely with the DRG Denials Specialist and/or designated representative from a Physician Advisor… more
- Catholic Health (Buffalo, NY)
- …identification of root cause and process improvement opportunities to eliminate recurring clinical denials . The position acts as a liaison between front-end ... denied due to reasons including, but not limited to clinical documentation/support for diagnostic related grouping ( DRG )...(3 ) years of experience monitoring, reviewing and appealing clinical denials or relevant experience preferred +… more
- Covenant Health Inc. (Knoxville, TN)
- …of documentation, and the appropriate assignment of a final DRG . The CDI Specialist functions as a resource for clinical staff and other groups involved in ... Overview Clinical Documentation Integrity Specialist Full Time,...discharge planning of patients. In order to assure appropriate DRG assignment and the validity and reliability of the… more
- Tidelands Health (Myrtle Beach, SC)
- …the Standards of Ethical Coding as set forth by AHIMA. Abstracting required clinical information from the medical record. Queries physicians as needed, to clarify ... and Risk of Mortality (ROM), best Diagnostic Related Group ( DRG ) outcome, and accurate assignment of present on admission...allow for payer processing for payment. + Collaborate with Clinical Documentation Integrity (CDI) team as part of the… more
- Granville Medical Center (Oxford, NC)
- … is responsible for improving the overall quality and completeness of our clinical documentation. The CDI Specialist is responsible for interacting with ... secondary diagnoses, principal and secondary procedures concurrently to promote appropriate DRG , APC, and ER Leveling assignments. Responsible for identifying and… more
- Granville Health System (Oxford, NC)
- … is responsible for improving the overall quality and completeness of our clinical documentation. The CDI Specialist is responsible for interacting with ... secondary diagnoses, principal and secondary procedures concurrently to promote appropriate DRG , APC, and ER Leveling assignments. Responsible for identifying and… more
- Novant Health (NC)
- … clinical documentation improvement operations. The Coding Audit Response Specialist will support the Corporate Coding Audit Response Lead/Supervisor by ... Job Summary The Coding Audit Response Specialist position responds to external and internal audits...and successes, accurate and timely processing of account details, denials , and be able to capture and communicate information.… more
- HonorHealth (Scottsdale, AZ)
- …urgent care services, a cancer care network, outpatient surgery centers, clinical research, medical education, a foundation, an accountable care organization, ... Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization of health care services with the… more
- Banner Health (Remote, OR)
- …to claim submission; to identify possible opportunities for improvement of clinical documentation and accurate MS- DRG , Ambulatory Payment Classification (APC) ... assure the use of proper diagnostic and procedure code assignments. Collaborates on DRG and coding denials , billing edits/rejections to provide coding expertise… more
- Sanford Health (Sioux Falls, SD)
- …including diagnosis and procedural coding for working diagnosis related group ( DRG ) assignments. Workflows may include patient chart review, and assisting with ... and managing of insurance coverage and denials , prior authorizations, scheduled procedures, same-day readmission reviews, as well as length of stay. Ensure… more