Talent.com
Certified DRG Reviewer
Certified DRG ReviewerVirtualVocations • San Francisco, California, United States
Certified DRG Reviewer

Certified DRG Reviewer

VirtualVocations • San Francisco, California, United States
job_description.job_card.variable_days_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
job_description.job_card.job_description

A company is looking for a DRG Reviewer to join their remote Payment Integrity team.

Key Responsibilities

Analyze and review inpatient claims for adherence to Official Coding and Reporting Guidelines for ICD-10-CM / PCS codes

Conduct comprehensive initial reviews and screenings to verify clinical support for coded diagnoses

Achieve a production goal of 15-20 claims per day, increasing to 20 claims / day after six months, maintaining 95% accuracy in claim reviews

Required Qualifications

Must hold and maintain one of the following certifications : Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC), or Registered Health Information Technician (RHIT)

A minimum of 3 years of experience in acute care inpatient coding or auditing

Bachelor's degree required

Experience level : Experienced

serp_jobs.job_alerts.create_a_job

Reviewer • San Francisco, California, United States

Job_description.internal_linking.related_jobs
Arkansas Licensed Dental Reviewer

Arkansas Licensed Dental Reviewer

VirtualVocations • Hayward, California, United States
serp_jobs.job_card.full_time
A company is looking for a Dental Medical Reviewer - PRN (Remote U.Key Responsibilities Oversee utilization review / management activities including peer reviews and clinical consultations Collabo...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Field Reimbursement Manager

Field Reimbursement Manager

VirtualVocations • Santa Clara, California, United States
serp_jobs.job_card.full_time
A company is looking for a Field Reimbursement Manager (FRM) to minimize reimbursement and access barriers for patients and providers. Key Responsibilities Act as a compliant subject matter expert...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Kentucky Licensed RN QA Manager

Kentucky Licensed RN QA Manager

VirtualVocations • Fremont, California, United States
serp_jobs.job_card.full_time
A company is looking for an RN Quality Assurance Manager.Key Responsibilities Lead the development and execution of the clinical quality assurance program, including chart audits and provider fee...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_1_day • serp_jobs.job_card.promoted
X-Ray Technologist Advanced

X-Ray Technologist Advanced

Simonmed Imaging • Montara, CA, US
serp_jobs.job_card.full_time
Join the fastest growing outpatient radiology practice in the Nation- SimonMed Imaging! Our commitment to excellence and improving patient care paired with the best-in-class technology allows us to...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Risk Management Associate

Risk Management Associate

VirtualVocations • Fremont, California, United States
serp_jobs.job_card.full_time
A company is looking for a RMBC Core Associate III.Key Responsibilities : Evaluates, makes decisions, and processes policies based on Individual Risk Management Policy Investigates and resolves c...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Certified Registered Nurse Anesthetist (CRNA)

Certified Registered Nurse Anesthetist (CRNA)

Cross Country Locums • Vallejo, CA, US
serp_jobs.job_card.full_time
Types of cases : General surgery, podiatry, urology, ENT, dental (peds), GYN, total joint (lower extremities), neurosurgery, ortho trauma, trauma, OB. How many CRNA’s and how many anesthesiolog...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Home Health Coding & OASIS Reviewer

Home Health Coding & OASIS Reviewer

VirtualVocations • Oakland, California, United States
serp_jobs.job_card.full_time
A company is looking for a Per Diem Coding & OASIS Reviewer.Key Responsibilities Review patient charts for home health coding and OASIS assessments Educate clients on trends related to coding an...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Credit Reviewer II

Credit Reviewer II

East West Bancorp • San Francisco, CA, US
serp_jobs.job_card.full_time
East West Bank is currently seeking a Credit Reviewer II.The Credit Reviewer II will conduct loan and credit file reviews to assess the adequacy and effectiveness of the Bank's credit risk manageme...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Licensed Clinical Reviewer

Licensed Clinical Reviewer

VirtualVocations • Concord, California, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Reviewer of Behavioral Health.Key Responsibilities Review medical records to determine medical appropriateness based on contract requirements Monitor and adju...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Post Market Surveillance Director

Post Market Surveillance Director

Bio-Rad Laboratories • Hercules, CA, United States
serp_jobs.job_card.full_time
As the Post Market Surveillance Director, you will lead a global team responsible for monitoring product performance and ensuring regulatory compliance after release to market.Your day will involve...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Massachusetts Licensed RN Reviewer

Massachusetts Licensed RN Reviewer

VirtualVocations • San Francisco, California, United States
serp_jobs.job_card.full_time
A company is looking for an RN Utilization Management Reviewer.Key Responsibilities : Conduct pre-certification, concurrent, and retrospective reviews focusing on utilization management and care c...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Licensed Quality Auditor RN

Licensed Quality Auditor RN

VirtualVocations • Fremont, California, United States
serp_jobs.job_card.temporary
A company is looking for a Quality Auditor RN for a 6-month contract.Key Responsibilities Execute chart audits according to established guidelines and complete the required volume of reviews Ide...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
RN Clinical Quality Auditor

RN Clinical Quality Auditor

VirtualVocations • Concord, California, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Quality Auditor, RN - Remote.Key Responsibilities : Review and audit contracted sub-delegates Assist with report preparation and records regarding work functio...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
Director of Reimbursement

Director of Reimbursement

VirtualVocations • Oakland, California, United States
serp_jobs.job_card.full_time
A company is looking for a Director of Reimbursement (Remote).Key Responsibilities Oversee government payor reporting and ensure timely filing of cost reports Manage invoicing and compliance for...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Associate Director GRADS Compliance Partner, REMS and PV (Remote)

Associate Director GRADS Compliance Partner, REMS and PV (Remote)

Jazz Pharmaceuticals • Palo Alto, CA, United States
serp_jobs.filters.remote
serp_jobs.job_card.full_time
If you are a current Jazz employee please apply via the Internal Career site.Jazz Pharmaceuticals is a global biopharma company whose purpose is to innovate to transform the lives of patients and ...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
RN Clinical Review Manager

RN Clinical Review Manager

VirtualVocations • Fremont, California, United States
serp_jobs.job_card.full_time
A company is looking for a Manager of Clinical Review to oversee clinical operations and ensure high-quality patient care. Key Responsibilities Monitor quality of care and compliance with policies...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
Field Reimbursement Manager, WV

Field Reimbursement Manager, WV

VirtualVocations • San Francisco, California, United States
serp_jobs.job_card.full_time
A company is looking for a Field Reimbursement Manager specializing in Immunology, Pulmonology, and Gastroenterology.Key Responsibilities Collaborate with sales and medical teams to support healt...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_1_day • serp_jobs.job_card.promoted
Certified Risk Adjustment Analyst

Certified Risk Adjustment Analyst

VirtualVocations • Fremont, California, United States
serp_jobs.job_card.full_time
A company is looking for a Senior Compliance Risk Adjustment Analyst.Key Responsibilities Serve as the point of contact for external audits, managing deliverables and inquiries Quality review al...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted