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

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

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

Providence is calling a Senior Pre Service Specialist who will work remotely within our footprint states, AK, CA, OR, WA, TX, NM, or MT. Under the direction of the Pre Service Supervisor/Manager/Director, the Senior Pre Service Specialist has a clear understanding and knowledge of all functions performed by Pre Service. They are responsible for, but not limited to, schedu

Senior Coder Remote. Most States Eligible. Applies ICD 10/CM/PCS and CPT 4 codes to medical records based on documentation provided by physicians. Adheres to strict federal coding rules and guidelines in selecting codes that appropriately reflect the condition, which the patient had, severity of illness and the care that was provided. Abstracts clinical and statistical in

Coding Quality Auditor 100% Remote, Most States Eligible. The Coding QI Compliance Auditor and Trainer II is critical to the coding compliance program. By performing audits of hospital coding, training new coding staff, preparing and presenting educational sessions for the coders and staying current with official coding guidelines and regulations, the incumbent ensures th

Providence St. Joseph Health is calling a Senior Coder, Inpatient to work remotely within our footprint states AK, CA, MT, OR, TX and/or WA. Applies ICD 10/CM/PCS and CPT 4 codes to medical records based on documentation provided by physicians. Adheres to strict federal coding rules in selecting codes that appropriately reflect the condition, which the patient had, and th

Coder 100% Remote, Most States Eligible Under the direction of the Coding Manager, the Coder appropriately assigns MS/DRG's, ICD, and CPT codes to all account types according to American Hospital Association (AHA) and Uniform Hospital Discharge Set (UHDDS) guidelines. This individual abstracts clinical data and assists in regular analyses of patient records. In addition,

Coder 100% Remote, Most States Eligible Under the direction of the Coding Manager, the Coder, Emergency Department Remote appropriately assigns MS/DRG's, ICD, and CPT codes to all account types according to American Hospital Association (AHA) and Uniform Hospital Discharge Set (UHDDS) guidelines. This individual abstracts clinical data and assists in regular analyses of p

Providence caregivers are not simply valued they're invaluable. Join our team and thrive in our culture of patient focused, whole person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Providence is calling a Senior Coding Quality Educator who will Assis

Senior Coder \ Remote Most states eligible\ Applies ICD 10/CM/PCS and CPT 4 codes to medical records based on documentation provided by physicians. Adheres to strict federal coding rules and guidelines in selecting codes that appropriately reflect the condition, which the patient had, severity of illness and the care that was provided. Abstracts clinical and statistical i

Associate Coding Quality Auditor Remote, Most States Eligible. Revenue Cycle is the name adopted to reflect the Providence employees who work throughout Providence Health & Services (PH&S) in revenue cycle systems and structures in support of our ministries and operations in all regions from Alaska to California. ORC's objective is to ensure our core strategy, One Ministr

Senior Pre Service Specialist \ Remote\ Under the direction of the Pre Service Supervisor/Manager/Director, the Senior Pre Service Specialist has a clear understanding and knowledge of all functions performed by Pre Service. They are responsible for, but not limited to, scheduling, Pre Registration, estimates and collections, authorization verification and notice of admis