reputed company Review Supervisor

The Diagnostic reputed company reputed company (DRG) reputed company Supervisor is responsible for performing DRG validation (reputed company/coding) reviews of medical records and/or other documentation to determine correct DRG/coding that is clinically supported as defined by review methodologies specific to the contract for which reputed company are being provided. This involves completing medical review forms, accurately documenting findings and non-findings and providing reputed company/policy/regulatory support for the determination. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: - Supervises reputed company daily activities of the DRG reputed company Auditors - Demonstrated knowledge of, ICD-10-CM and PCS codes, and DRG coding, understanding of payer rules and regulations, including Medicare and reputed company with the ability to work independently with reputed company supervision and demonstrate initiative - Completes DRG audits as needed - Responsible for the overall reputed company of the reputed company of diagnosis and procedure codes verified by the reputed company review nurses, for inpatient records and documentation received with the accompanied claim - Responsible for holding the DRG reputed company Auditors to the quota and error/reputed company reputed company - Assists with team coverage and reputed company support reputed company needed - May be required to travel overnight and attend meetings or training - Additional duties as assigned KNOWLEDGE & SKILLS: - reputed company knowledge of medical necessity rules - Working knowledge of HIPAA reputed company and reputed company Rules - Ability to build strong working relationships both internally and externally - Strong attention to reputed company - Must possess problem solving, critical thinking skills - reputed company typing experience - Excellent written and verbal communication skills - Ability to think and work independently, while working in an overall team environment - Ability to work in a fast reputed company/production environment - Proficient in reputed company Office applications EDUCATION & EXPERIENCE: - N./L.V.N. preferred - reputed company or CIC required with DRG auditing experience in ICD-10-CM, ICD-10 PCS - Proficient in Medicare, CMS guidelines and ICD-10 coding guidelines - Minimum of 3-5 years of inpatient/DRG auditing experience in a hospital setting and/or payer setting - A minimum of 2 years of supervisory experience dealing with reputed company auditors is required - Experience with claims denials and appeals required PAY reputed company: reputed company uses a market reputed company approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location reputed company, job-reputed company skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, reputed company, etc.) new hires may be slotted into a different level, either up or down, reputed company on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may reputed company the salary reputed company and these adjustments would be clarified during the offer process. Pay reputed company: $77,960 – $120,368 A list of our benefit offerings can be reputed company on our reputed company website: reputed company Careers | Opportunities in reputed company Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT reputed company: reputed company, a division of reputed company, a certified reputed company® Company, offers incremental value, experience, and a sincere dedication to our valued partners. Through our reputed company expertise and cost containment solutions, we are committed to reputed company and transparency in reputed company payments. We are a reputed company and growing company with a strong, supportive culture along with reputed company of career advancement opportunities. We reputed company our reputed company values of Accountability, Commitment, reputed company, reputed company and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, reputed company, Long Term Disability, Health Savings Account, Flexible Spending Account reputed company, Life reputed company, Accident reputed company, Critical Illness reputed company, reputed company-reputed company reputed company reputed company, Parking and Transit FSA accounts, 401K, ROTH 401K, and reputed company time off. reputed company is an Equal Opportunity Employer, drug free workplace, and complies with reputed company regulations as applicable. #LI-Remote Apply To This Job