As a valued member of the DRG Review Team, the DRG Integrity Specialist performs a secondary level review of medical records and code assignment using knowledge of Accuity technology and client systems with a physician in accordance with federal coding regulations and guidelines as well as client specific coding guidelines to ensure accurate DRG assignment. This function

This position is responsible for validating and entering patient and insurance information into proprietary billing software. The ideal candidate will be well versed in billing guidelines, insurance guidelines, and responding to patient and insurance inquiries. The medical biller will also be responsible for maintaining patient confidentiality and accurately inputting pat

Performs review of the medical record including documentation, reports, flowsheets, and test results, applying evidence based criteria related to DRG and clinical validation denials Creates appeal letters utilizing the relevant information from the medical record; supported by current clinical standards and facility guidelines, evidence based medicine, professionally reco

Assigns appropriately sequenced and compliant ICD 10 CM/PCS codes as documented in the electronic medical record (EMR). Applies definition of principal diagnosis for proper assignment of MS DRGs, APR DRGs, and POA indicators using a designated encoder/grouper, while ensuring compliance with nationally established coding guidelines. Utilizes selected encoder and/or compute

As a valued member of the DRG Review Team, the DRG Integrity Specialist performs a secondary level review of medical records and code assignment using knowledge of Accuity technology and client systems with a physician in accordance with federal coding regulations and guidelines as well as client specific coding guidelines to ensure accurate DRG assignment. This function

As a valued member of the DRG Review Team, the DRG Integrity Specialist performs a secondary level review of medical records and code assignment using knowledge of Accuity technology and client systems with a physician in accordance with federal coding regulations and guidelines as well as client specific coding guidelines to ensure accurate DRG assignment. This function

Review pre bill cases simultaneously with a physician during each work shift excluding breaks and meetings to analyze and validate diagnosis and procedure codes for inpatient services via coding compliance and clinical knowledge to support accurate DRG assignment Utilizes Accuity technology for tracking of coding errors, query opportunities and other data collection as ne

Assess the clinical indicators and suggestions of various query requests received from the MD Reviewer/ DRG Integrity Specialist Collaborate and communicate as necessary to clarify and avoid misinterpretation to ensure the query is optimally written and distributed to the correct client provider Creates queries in a compliant manner in accordance with AHIMA and ACDIS comp

Centennial Peaks Hospital has been providing psychiatric services to the Denver metro area for more than 30 years. Located in beautiful Louisville, CO, our 104 bed facility provides a peaceful setting for those seeking treatment for mental illness including chemical dependency. Centennial Peaks offers unique and individualized programming for adolescents and adults that s

Include Ensure patient demographic information is accurate and complete Utilize customer hospital systems or approved vendors to research and obtain/verify patient demographic information Validate signature documents such as AOB (Assignment of Benefits), consents, CMN (Certificate of Medical Necessity) Verify patient name is consistent on all documents Verify date of servi

The purpose of this position is to perform all professional coding responsibilities for an assigned group of clinics and/or providers. Scope 1.Assigns ICD, CPT and HCPCS coding classifications based on clinical documentationand/or physician orders. Utilizes appropriate tools, resources and guidelines to determine codes and assign principal and secondary diagnoses. Obtains

BILLING RECORDS ASSOCIATE Job Locations US CO LONGMONT ID 2024 142166 Line of Business PharMerica Position Type Full Time Pay Min USD $18.50/Hr. Pay Max USD $22.00/Hr. Our Company PharMerica Overview Join our PharMerica team! PharMerica is a closed door pharmacy where you can focus on fulfilling the pharmaceutical needs of our long term care and senior living clients. We

BILLING RECORDS ASSOCIATE Job Locations US CO LONGMONT ID 2024 140139 Line of Business PharMerica Position Type Full Time Pay Min USD $18.50/Hr. Pay Max USD $22.00/Hr. Our Company PharMerica Overview Join our PharMerica team! PharMerica is a closed door pharmacy where you can focus on fulfilling the pharmaceutical needs of our long term care and senior living clients. We

The Clinical Documentation Specialist ensures clinical documentation is accurate, consistent, compliant, and specific through the performance of reviews and initiation of queries to providers to achieve appropriate ICD 10 code and DRG (Diagnosis Related Groups) assignment for each patient. Reviews concurrent documentation of the medical record to realize accurate and comp

Provides extraordinary care to our customers through friendly, courteous, and professional service through a broad understanding of account handling processes, extraordinary interpersonal skills, and the ability to resolve complex issues in a timely and accurate manner. Scope As a Patient Account Rep II you need to know how to Review insurance aging reports Resubmit and w