DRG (Coding) Reviewer/Auditor - New York

· Position Summary · At MedReview, our mission is to bring accuracy, accountability, and clinical excellence to healthcare.  As such, we are a leading authority in payment integrity solutions including DRG Validation, Cost Outlier and Readmission reviews. · Under the direction ...

We're seeking a Clinical DRG Auditor to perform inpatient Diagnosis-Related Group (DRG) validation audits and detailed clinical reviews of medical records and claims. · Active Registered Nurse (RN) license or Licensed Practical Nurse (LPN) license. · 3+ years of experience perfor ...

Summary Of Position · Responsible for upholding the standard for code review functions in the setting of business/industry/legislative issues relating to, and impacting, quality coding audit and compliance issues. Identify inconsistencies and coding compliance risks between EH re ...

The Coding Integrity Auditor is responsible for upholding coding standards in business/industry/legislative issues related to quality coding audit and compliance. · Bachelor's degree in healthcare or related field · AAPC certifications (CPC, CIC) · ...

Overview · The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These ...

Provides consultative services for quality improvement activities at VNS Health Plans.Collaborates with clinical management to develop quality improvement standards. · Evaluates effectiveness of standards and recommends changes. · Ensures Quality Improvement programs align with C ...

This position provides consultative services and manages quality improvement activities for VNS Health Plans. The Quality Reviewer/Auditor contributes to the development of whole system measures and annual Enterprise quality strategic plan. · ...

Provides consultative services and manages quality improvement activities and initiatives for VNS Health Plans. · ...

The Inpatient DRG Validation Auditor is a valued member of the Penstock Audit team responsible for reviewing inpatient claims and ensuring that the DRG paid is fair and accurate based on the documentation in the medical record and the application of ICD-10-CM and ICD-10-PCS codin ...

Remote DRG Validator and Quality Reviewer performs inpatient coding and DRG validation & other reviews by verifying coding accuracy & compliance. · ...

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-qualit ...

Description · The purpose of DRG validation is to confirm that diagnostic, procedural information, and the discharge status of the beneficiary, as coded and reported by the hospital on its claim, matches both the attending physician's description and the information contained in ...

We're seeking an experienced · Perform APR-DRG inpatient reviews and validate severity captureLead Risk of Mortality (ROM) and POA coding reviews and reportingReview HACs, PPCs, PSIs, · , and expired patient recordsStrong IP/OP Auditing / coding experience,Advanced knowledge of ...

· Job Description · The purpose of DRG validation is to confirm that diagnostic, procedural information, and the discharge status of the beneficiary, as coded and reported by the hospital on its claim, matches both the attending physician's description and the information contai ...

The purpose of DRG validation is to confirm that diagnostic, procedural information and the discharge status of the beneficiary as coded and reported by the hospital on its claim matches both the attending physician's description and the information contained in the beneficiary's ...

The Mount Sinai Health System is committed to fostering an environment where everyone can contribute to excellence. We share a common dedication to delivering outstanding patient care. When you join us, you become part of Mount Sinai's unparalleled legacy of achievement, educatio ...

The purpose of DRG validation is to confirm that diagnostic procedural information and the discharge status of the beneficiary as coded by the hospital matches both attending physician description. · The Clinical Reimbursement Manager reviews medical records for quality accuracy ...

The purpose of DRG validation is to confirm that diagnostic, procedural information, and the discharge status of the beneficiary matches both the attending physician's description and the information contained in the medical record. · The Clinical Reimbursement Manager reviews qu ...

The purpose of DRG validation is to confirm that diagnostic, procedural information, and the discharge status of the beneficiary as coded and reported by the hospital on its claim matches both the attending physician's description and the information contained in the beneficiary' ...

Financial Analyst / Senior Accountant (Temp) · Location: New York, NY Hybrid) · Schedule: Monday – Friday | 9:00 AM – 5:00 PM | 35 hours per week · Duration: 3+ months (Possible extension based on performance) · Pay Rate: $60 – $65 per hour · Start Date: 03/30/2026 · Job Summary ...