5 utilization management rn coder jobs found

TREND Health Partners is a tech-enabled payment integrity company. Our mission is to facilitate collaboration between payers and providers for mutual benefit and waste reduction, ultimately improving access to healthcare. We achieve this by aligning the common goals of payers and providers and fostering collaboration through a shared technology platform and seamless workflows. Joining TREND Health Partners means becoming part of a dynamic, growing organization that promotes a collaborative and innovative work environment. Our comprehensive compensation package includes competitive salaries, highly valued health insurance, a 401(k) plan with employer match, paid parental leave, and more. The Nurse Coder DRG Auditor’s primary responsibility is to review medical records and associated claim information to validate accuracy of DRG assignments and/or medical necessity for inpatient level of care. This role will apply coding and clinical principles based on industry standards and...

Certified Professional Coder Job Location: Hopewell, NJ Job Duration: 6 Months (possibility of extension) Payrate: $35 - $38/ hr. on w2 Job Summary: This position is responsible for leading on-site and desk audits of hospital billing and coding practices, including forms development, audit profiling, and tracking institutional audit trends. The role involves designing audit protocols, handling special projects, and performing/finalizing per diem audits, bill verification, DRG validation (utilization review audits), and credit balance reviews. The position also provides education and guidance on ICD-10-CM coding, DRG assignment, payment methodologies, and auditing practices. Key Responsibilities: Lead hospital billing and coding audits, both on-site and remote Identify and present billing discrepancies and coordinate improper claim payment referrals Analyze trends related to documentation, billing errors, and provider contract interpretation issues Compile audit...

Job Title: Certified Professional Coder Job Location: Hopewell, NJ Job Duration: 6 Months (possibility of extension) Payrate: $35 - $38/ hr. on w2 Job Summary: This position is responsible for leading on-site and desk audits of hospital billing and coding practices, including forms development, audit profiling, and tracking institutional audit trends. The role involves designing audit protocols, handling special projects, and performing/finalizing per diem audits, bill verification, DRG validation (utilization review audits), and credit balance reviews. The position also provides education and guidance on ICD-10-CM coding, DRG assignment, payment methodologies, and auditing practices. Key Responsibilities: Lead hospital billing and coding audits, both on-site and remote Identify and present billing discrepancies and coordinate improper claim payment referrals Analyze trends related to documentation, billing errors, and provider contract interpretation issues...

Clinical Data Coder Our corporate activities are growing rapidly, and we are currently seeking a full-time, office-based Clinical Data Coder to join our Clinical Coding & Support team in Cincinnati, OH. This position will work on a team to accomplish tasks and projects that are instrumental to the company's success. If you want an exciting career where you use your previous coding, pharmacy, or nursing expertise and can develop and grow your career even further, then this is the opportunity for you! Responsibilities Perform accurate coding of medical terms and medications utilizing industry-wide standards as well as company standards; Coordinate the assignment of appropriate dictionaries for meeting study requirements Develop and maintain coding guidelines; Issue queries on adverse events, medications, and medical history terms to ensure high quality coding; Work collaboratively with the Medical, Data Management, Safety and Biostatistics teams to meet needs of...

Coder III Coder III is responsible conducting clinically based concurrent and retrospective reviews of inpatient medical records. This review is to evaluate that the clinical documentation is reflective of quality of care outcomes and reimbursement compliance for acute care services provided. The CDS will work closely with the medical staff to facilitate appropriate clinical documentation of patient care. The CDS/Coder III abstracts and codes the diagnostic and procedural information for Inpatient Services and Surgery medical records utilizing the current version of International Classifications of Diseases in accordance with regulatory agencies and hospital specific guidelines. The CDS/Coder III enters the coded data and other abstracted data from the medical record into the electronic information system. This position assumes primary responsibility for clarifying ambiguous documentation, DRG optimization with the primary role in assisting medical staff members with improving...