Medix
Jericho, NY, USA
JOB TITLE: DRG/CPD Coder OVERVIEW: Seeking Coders to join the DRG Review team. These coders are working with NY Medicaid to review high cost claims and may be up to multimillion dollar claims. The target background is a medical coder with a strong DRG background. Candidates should have inpatient experience or open to someone with outpatient or a blend. Coder will be receiving claims that have already been decided and then it is up to them to review the claim and the decision and then be able to write a summary explaining why they are upholding or overturning the decision and be able to quote the chart or the coding guidelines to substantiate. Coder will be handling anywhere from 10-12 claims a day, depending on the complexity of the claim. DUTIES: Validate and verify submitted codes for DRG validation. Apply national coding standards and regulations to the claims and clinical data. Provide subject matter input and support agency-wide projects. Other duties as...