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

Seeking experience working with key DER stakeholders and familiarity with stakeholder forums advancing DER interconnection and distribution system planning for New York Experienced in energy project analysis, modeling, regulation, utility operations or independent system operator functions Contribute to the State's strategic decision making relating to DER interconnection

ABOUT US With energy and purpose, Cooley Dickinson Health Care, a member of the Mass General Brigham system, is advancing health care in western Massachusetts, and has been since 1886. Our network employs more than 2,000 medical professionals and support staff, at our main Hospital campus in Northampton and additional locations in twelve towns throughout the Pioneer Valle

Why This Role is Important to Us The Advisor will be responsible for data analysis and data sets for consumer measurement programs throughout the organization. Advisor will identify themes, trends, and correlations across data sets and measures and tell the story with compelling data visualizations. Advisor will lead research activities, in depth data analysis, and creati

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

The DRG Validation Nurse Reviewer will be primarily responsible for conducting post service, pre payment and post pay comprehensive inpatient DRG reviews based on industry standard inpatient coding guidelines and rules, evidence based clinical criteria plan, and policy exclusions. Conduct reviews on inpatient DRG claims as they compare with medical records ICD 10 Official

Health Information Supervisor Job Locations US MA Worcester | US MA Framingham | US MA Natick Requisition ID 2024 35060 # of Openings 0 Category (Portal Searching) Operations Position Type (Portal Searching) Employee Full Time Overview Who we are... Datavant protects, connects, and delivers the world's health data to power better decisions and advance human health. We are

OF MINIMUM QUALIFICATIONS Education and/or experience equivalent to a bachelor's degree in science, or related field. Four (4) years of clinical data management experience. Knowledge of clinical trials data processing concepts. Demonstrated knowledge of data management processing systems. Demonstrated experience in all areas of data management database build, database main

The HCC Coding Specialist working under the direction of the Supervisor, determines the appropriate HCC clinical rules that follows the Official Guidelines for Coding and Reporting and Risk Adjustment guidelines for Hierarchical Condition Categories (HCC). HCC Coding is a risk adjustment model designed to estimate future costs for patients. HCC coding relies on ICD 10 CM

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

The Referral Coordinator is responsible for the handling of referrals, processing authorizations and scheduling appointments. Principal Duties Use/s the Mass General Brigham values to govern decisions, actions and behaviors. These values guide how we get our work done Patients, Affordability, Accountability & Service Commitment, Decisiveness, Innovation & Thoughtful Risk;

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

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

Under the general direction of the Manager or designee, the Healthcare Data Analyst II will perform data analyses for assigned projects and develop/ produce all related reports. This position will conduct information gathering to provide leadership with the necessary tools to determine the best data analytic practices to position the business unit for addressing client ne