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Accuity
Boston, MA, United States
Job Type Full-time Description POSITION SUMMARY: 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 s
Job Source: AccuityBoston Children’s Hospital
Boston, MA, United States
Job Summary This Revenue Integrity Specialist will be responsible for: Overseeing revenue cycle operations for Department with the goal of maximizing revenue by implementing recommended processes and functions in compliance of internal controls. Reviews charge activity work queues and releases charges from Epic to payers in compliance with Charg
Job Source: Boston Children’s HospitalEncore Fire Protection
Needham, MA, United States
Overview: Naturally outgoing, detail-oriented, and unapologetically persistent are just a few of the words I'd use to describe the ideal System Integrity Specialist. The people that do best in this position are often the people called out for being able to start a conversation with just about anyone but known to never take no for an answe
Job Source: Encore Fire ProtectionGeneris Tek Inc
Boston, MA, United States
Please Contact: To discuss this amazing opportunity, reach out to our Talent Acquisition Specialist Nitika Rao at email address [email protected] can be reached on # 630-576-1924. We have Permanent role for Inpatient Coding Specialist-Remote f or our client Nashville TN. Please let me know if you or any of your friends would be intere
Job Source: Generis Tek IncAccuity
Boston, MA, United States
Job Type Full-time Description The Medical Director, working together with a coder (DRG Integrity Specialist), will review inpatient charts to ensure the acuity and complexity of the patient's hospital stay is appropriately captured in the clinical documentation and translated into coding. The Medical Director is responsible for capturing the true
Job Source: AccuityBeth Israel Lahey Health
Boston, MA, United States
When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. Job Type: Regular Scheduled Hours: 40 Work Shift: Day (United States of America) The Revenue Integrity Billing Specialist role specializes in enrollment & revenue integrity issues relating to professional billing. This role is respon
Job Source: Beth Israel Lahey HealthBeth Israel Lahey Health
Needham, MA, United States
Job Type: Regular Time Type: Full time Work Shift: Day (United States of America) FLSA Status: Non-Exempt When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. Under the direction of the Manager of Health Information Management, the HIM Data Integrity Specialist I is responsible for ma
Job Source: Beth Israel Lahey HealthZelis Healthcare
Boston, MA, United States
Position Overview : The Manager, DRG Validation of the Expert Claims Review (ECR) department is responsible for daily operations and team management of the DRG product. The Manager, DRG Validation will be primarily responsible for the oversight of DRG validation reviews to ensure accurate and compliant coding based on industry standard inpatient
Job Source: Zelis HealthcareBoston, MA, United States
Job Type
Full-time
Description
POSITION SUMMARY:
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 requires a broad knowledge of the compliance structure to support the appropriate reimbursement.
PRIMARY JOB RESPONSIBILITIES:
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 needed
Researches, analyzes, and responds to inquiries regarding compliance, inappropriate coding, and client denials
Possesses a high level of dependability and ability to meet Accuity coding recommendations, accuracy rate, and production standards
Interacts with Accuity physicians, peers, CDIS, and management regarding documentation, policies, procedures, and regulations
Interacts with management on an ongoing basis including assisting senior level staff in providing recommendations for process improvement so that productivity and quality goals can be met or exceeded, and operational efficiency and financial accuracy can be achieved
Reviews, develops, modifies, and/or adapts relevant client procedures, protocols, and systems to coordinate with Accuity methodology
Creates and provides group education and training based on accurate coding practices, coding compliance documentation, and regulatory provisions
Attends in-house training sessions to receive updated coding information and changes in coding and/or regulations
Adheres to stringent timelines consistent with project deadlines and directives
Ensures strict confidentiality of patient medical records
Always acts in an ethical and collaborative manner while monitoring own work to help ensure quality
Codes medical records as needed based on organizational needs
Performs miscellaneous job-related duties as assigned
Requirements
POSITION QUALIFICATIONS:
Education :
High School Diploma or GED required
Associates Degree in Health Information Management or similar preferred
Experience:
Minimum 4 years of inpatient coding experience in hospital facility coding
Minimum 2 years of experience that is directly related to the duties and responsibilities specified above
Experience and knowledge in DRG reimbursement (i.e., MS-DRG, APR-DRG)
Licensure and/or Credentials:
Coding credential required from AHIMA/AAPC (RHIA, RHIT, CCS and/or CPC, or CIC)
Knowledge, Skills, and Abilities:
Knowledge of auditing concepts and principles
Expert of coding guidelines
Ability to use independent judgment and to manage and impart confidential information
Advanced knowledge of medical coding, electronic medical record systems, coding systems
Critical thinking skills to analyze and solve problems
Strong communication and interpersonal skills
Knowledge of legal, regulatory, and policy compliance issues related to medical coding and documentation
Knowledge of current and developing issues and trends in medical coding diagnosis and procedure code assignment
Ability to clearly communicate medical information to physicians and CDIS staff
Ability to provide guidance and training to when needed
Ability to use a PC in a Windows environment, including MS Word
Independent, focused individual able to work remotely or on-site
Email Alert for DRG Integrity Specialist jobs in Boston, MA, United States
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