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Accuity
Philadelphia, PA, 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: AccuityAccuity
Mount Laurel Township, NJ, 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: AccuityAlpine Solutions Group
Camden, NJ, United States
DAY TO DAY: Our healthcare client is seeking a Revenue Integrity Specialist to join their emerging team as a full-time hybrid employee. In this role, you will focus on issues that come up reactively day to day concerning hospital and professional billing, ensuring charges are processed accurately, reporting on trends, and working across various dep
Job Source: Alpine Solutions GroupAccuity
Philadelphia, PA, 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: AccuityAccuity
Mount Laurel Township, NJ, 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 tru
Job Source: AccuityHenry Ford Health System
, PA, United States
The Revenue Integrity Specialist position identifies revenue opportunities and works collaboratively with Revenue Cycle staff to drive process improvement, educate clinical departmental staff, and document workflows. Primary areas of focus include increased revenue capture, compliance, and decreased denials. PRINCIPLE DUTIES AND RESPONSIBILITIES:
Job Source: Henry Ford Health SystemManagement Recruiters of Raleigh
, PA, United States
We have an excellent opportunity in Northwestern PA for an Integrity Engineer! About the Opportunity : Our client, an Independent Petroleum Company with operations in the northern US & Canada, has an excellent opportunity in its Warren, PA headquarters for a Pipeline Integrity Engineer. About the Position: This is an exciting opportunity to
Job Source: Management Recruiters of RaleighAccuity
Mount Laurel Township, NJ, United States
Job Type Full-time Description The Appeals and Denials Specialist is responsible for triaging and writing DRG downgrades and clinical validation appeal letters for multiple clients. The Appeals and Denials Specialist will ensure appropriate action is taken within appeal deadlines. This position collaborates with the Appeals and Denials team and o
Job Source: AccuityPhiladelphia, PA, 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 Philadelphia, PA, United States
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