- HSS (New York, NY)
- …committed to our Mission, you too can be part of our transformation across the enterprise. DRG Reviewer Full-Time The DRG Reviewer reports to the ... Director of Coding, HIM (Health Information Management). The DRG Reviewer oversees DRG accuracy....+ Monitors coding and documentation accuracy. + Conducts retrospective review of the medical record to increase accuracy, clarity,… more
- The Mount Sinai Health System (New York, NY)
- Maintains responsibility for coding/ DRG validation review , DRG PRO activities and assurance of optimal reimbursement. Oversees compliance with coding ... standards and regulations **Strength Through Diversity** The Mount Sinai Health System believes that diversity, equity, and inclusion are key drivers for excellence. We share a common devotion to delivering exceptional patient care. When you join us, you… more
- Hackensack Meridian Health (Hackensack, NJ)
- …Health Information Management (HIM) education. + Minimum of 5 years progressive coding review in ICD-10-CM and DRG methodologies. + Knowledge of POA/HAC, PSI ... serve as a leader of positive change. The **Diagnosis Related Group ( DRG ) Auditor** is responsible for auditing clinical documentation that supports code assignment… more
- Hackensack Meridian Health (Hackensack, NJ)
- …admissions and observations as specified by the facility's Utilization Management/ Review Committee for documentation completeness and compliance with patient status. ... in medical screening process by documenting appropriateness of patient admission, working DRG & LOS information on worksheet and computer system as appropriate. +… more
- Hackensack Meridian Health (Hackensack, NJ)
- …admissions and observations as specified by the facility's Utilization Management/ Review Committee for documentation completeness and compliance with patient status. ... the medical screening process by documenting appropriateness of patient admission, working DRG & LOS information on worksheet and computer system as appropriate. +… more
- Hackensack Meridian Health (Hackensack, NJ)
- …Hackensack Meridian Health includes: + Reviews Diagnosis Related Group ( DRG ) assignment for selected Medicare/Medicaid inpatients, Hospital-acquired condition (HAC), ... + Provides guidance on any changes made during their review to the Inpatient Coders by furnishing input as...and rationale (if needed) in 3M as needed for DRG mismatches on Clinical Documentation Improvement (CDI) reviewed cases.… more
- Hackensack Meridian Health (Hackensack, NJ)
- …and ICD-10-Procedure Coding System (PCS) codes creating diagnosis-related group ( DRG ) assignments. Abstracts pertinent information from patient records. + Sequence ... the diagnosis and procedures using coding guidelines and optimizing the DRG as applicable. + Addressing all edits, including but not limited to nosology, Exihauser,… more
- Northwell Health (Lake Success, NY)
- …the Medical Record. Job Responsibility + Leverages clinical expertise to identify and validate DRG code assignment + Full review of CDI suggested code changes + ... + Applies coding rules and regulations to the validation review process. + Reviews codes on Medicare/non-Medicare charts for...charts for compliance to rules and conventions. + Communicates DRG changes and rationale to the coding and CDI… more
- Catholic Health Services (Rockville Centre, NY)
- …required. CCDS certification required within 2 years of hire date Skills: Chart review skills with ICD 10CM.PCS experience preferred. Experience: Minimum of 5 years ... and procedures where inadequate or conflicting documentation exists. Verifies DRG assignment with medical record documentation and consults with...level of service rendered to all patients with a DRG based payor. Demonstrates knowledge of DRG … more
- Hackensack Meridian Health (Hackensack, NJ)
- …Morbidity, etc.) and clinical evidence to support Diagnosis-related group ( DRG ), principal diagnosis, and secondary diagnoses assignments. Enables accurate ... a discrepancy in the Clinical Documentation Specialist and Coder DRG and coaching of the CDMP Team on PSI....development and evaluation of staff competencies. + RAC - Review and distribute letters to appropriate departments, ie **Qualifications**… more
- Catholic Health Services (Rockville Centre, NY)
- …is received for the level of service rendered to all patients with a DRG based payor. Ensures the accuracy and completeness of clinical information used for ... received for the level of service rendered to all patients with a DRG based payor. Demonstrates proficiency in clinical documentation requirements for the accurate… more
- Hackensack Meridian Health (Hackensack, NJ)
- …BI reports to the appropriate leaders and supervisor the ultimate delegation to review and subsequent staff assignment. c. Performs data mining and in depth analysis ... Manage Governmental denials - work closely with Case Management, Utilization Review , Physician Advisors, Registration/Access & other departments that have impact on… more
- Catholic Health Services (Bethpage, NY)
- …Educate staff, physicians, patients, and families in the case management process. Review new admissions and continued stay patients to determine whether MCG criteria ... is met. Engage physicians to establish the optimal DRG , length of stay and expected date of discharge....for reviews in a timely fashion to avoid denials. Review records and collaborate with the interdisciplinary team to… more
- The Mount Sinai Health System (New York, NY)
- …Healing made personal. **_Roles & Responsibilities:_** + Responsible for the review and coding of complex inpatient and/or ambulatory surgery records utilizing ... preferred. Experience: Proficiency in the use of automated coding and DRG /AOC grouping software. **_Strength Through Diversity_** The Mount Sinai Health System… more
- Hackensack Meridian Health (Hackensack, NJ)
- …& aligned with established Desktop & policies & procedures. + Performs analytical review of denials to support Revenue Operations, Case Management, Access, and other ... Managed Care, the payer, or DTS. Monitors payments denials and initiates CPT or DRG analysis to determine reasons for denial. + Monitors daily dashboard and reports… more
- St. Joseph's Health (Paterson, NJ)
- …Job Overview: Responisble for accurate tracking of Diagnostic Related Group ( DRG ) denials to ensure appropriate reimbusement for services rendered. Works closely ... with Revenue Cycle Leadership and Physicians to review findings and determine appeal status. Assists with medical record merging for patient care and proper billing.… more