Identify appropriate assignment of ICD 10 CM and ICD 10 PCS Codes for inpatient services provided in a hospital setting and understand their impact on the DRG with reference to CC/MCC, while adhering to the official coding guidelines and established client coding guidelines of the assigned facility Abstract additional data elements during the Chart Review process when cod

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

Assists with the development of education and training of physicians, coders, and CDI specialists for Accuity Healthcare and provides coding component to all education programing, which may include preparation of related educational materials and giving frequent presentations on site and virtual Assists with the orientation programs and online learning module assignments

Provides education to medical providers as warranted. Description What You'll Do Communicates/educates providers on issues such as Medicare coverage, utilization statistics, documentation and medical review by use of written advisories, reports, letters, and telephone contacts. Documents all provider contacts/communications in provider tracking system. Conducts formal con

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

Posts payments based on explanation of benefits (EOBs) from insurance companies and government agencies in an accurate and timely manner Posts patient/guarantor payments received in person or via mail in an accurate and timely manner Transfers, adjusts, and refunds payments when appropriate for accounts Prepares and ensures accuracy of Daily Cash Report that is disseminat

Telecommute Healthcare Advocate

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

Responsible for providing and directing Physical Therapy services to patients, including assessment, treatment, program planning and implementation, related documentation, and communication. Functions under a physicians order. Required Skills Current, valid, and active license to practice as a Physical Therapist in the state of employment required. Current BLS certificati

Index documents into Epic (Norton's digital medical record system) that are sent from outpatient, physician practices. Store, retrieve, review, assess, and process health related information in both paper format and electronic format Contributes to overall patient safety, revenue cycle management and continuous quality improvement initiatives Serves as a resource for all

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

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

CLINICAL DENIALS MANAGEMENT AND AUDIT Job Locations US KY LOUISVILLE ID 2024 141285 Line of Business BrightSpring Health Services Position Type Full Time Our Company BrightSpring Health Services Overview Clinical Denials Management and Audit monitors, responds to, and performs the clinical denial and appeal processes across Home Health branches for all payor types strivin

Clinical Coding & Audit Specialist Job Locations US KY LOUISVILLE ID 2024 137732 Line of Business BrightSpring Health Services Position Type Full Time Our Company BrightSpring Health Services Overview The Clinical Coding and Audit Specialist monitors, responds and performs the clinical coding and audit support required to ensure timely processing of all episodes of care.