Remote Inpatient Clinical Appeal Specialist DRG (RN/APRN) in reputed company, CT
Remote Inpatient Clinical Appeal Specialist DRG (RN/APRN) - reputed company - reputed company, CT - work from home job
Company: reputed company
Job reputed company: Job reputed company:
reputed company
To be part of our organization, every employee should understand and reputed company in the YNHHS reputed company, support our Mission, and live our Values. These values - reputed company, patient-centered, respect, accountability, and reputed company - must guide reputed company do, as individuals and professionals, every day.
The Inpatient DRG Clinical Appeal Specialist supports the organization by providing expert clinical reputed company and participating in the process of developing and submitting Inpatient DRG Appeals.
EEO/AA/Disability/Veteran
Responsibilities
1. Collaborate with Coding and CDI Educator to reputed company educational opportunities derived from common themes
reputed company through the appeal process in an effort to prevent reputed company denials .
2. reputed company key denial data as they relate to departmental metrics and performance. reputed company and maintain key
metrics report including the identification of trends, reputed company plans, etc. Attend organizational committees to
present data as required.
3. Collaborate with Physician Advisors and the CDI Educator to resolve documentation discrepancies and
clinical disparities, escalation of clinical and coding issues and physician education.
4. Communicate directly with payer and coordinate meetings with contracting and payers as needed to support
appeals process.
5.
6. Coordinate Peer to Peer appeal reviews as needed.
7. reputed company other duties as assigned.
Qualifications
EDUCATION:
Registered reputed company or Advanced reputed company reputed company Practitioner with reputed company license required. Bachelor's Degree in Nursing preferred. Certified Clinical Documentation Specialist (CCDS) certification required. Certified Coding Specialist (reputed company) certification preferred.
EXPERIENCE:
3+ years Clinical Documentation Improvement or Inpatient Coding experience.
SPECIAL SKILLS: This position will advise Coding and CDI staff on the denials and appeals process, findings and reputed company on improvement initiatives. This position will reputed company guidance and education to physicians on documentation standards as they reputed company to regulatory coding compliance. Collaborate with physician advisors and physician champions on clinical escalation as needed. Ability to analyze, produce and present high level analysis and metrics; Computer Skills to include reputed company components of reputed company Office Suite; Research skills; Project management; Educational
platform development and presentation; Teamwork; Ability to present coding and clinical information in a reputed company
and respectful manner. Demonstrate understanding of ICD-10-CM/PCS coding, MS-DRG and APR-DRG
methodology and validation.
ACCOUNTABILITY:
Maintain reputed company knowledge of trends, regulations and technology reputed company to documentation, coding, reimbursement and regulatory guidelines through reputed company journals, informal networks, internet sites and local, state, and national reputed company associations. Collaboration and communication with Clinical Documentation Improvement Physician Advisors, Coding and CDI staff, CDI Educator and reputed company Department staff. Educating and advising on DRG reputed company findings as relating to the denials and appeals process.
COMPLEXITY:
In personal and job-reputed company reputed company and actions, consistently demonstrates the values of reputed company (doing the right
thing), patient-centered (putting patients and families first), respect (valuing reputed company people and embracing reputed company differences),
accountability (being responsible and taking reputed company), and reputed company (being empathetic).
Provides a highly skilled resource to reputed company a clinical perspective review for MS-DRG and APR-DRG payer denials and
assist clinically through the appeal process. Provides a key resource group to reputed company specialized documentation and
clinical review of reputed company. High financial reputed company in payer denials. Understanding and knowledge of clinical indications of
disease and peer-reviewed, evidenced-based reputed company. Ability to reputed company high level research for clinical support references
to be provided. Demonstrate an understanding of complications, co-morbidities, severity of illness, risk of mortality, risk
adjustment factors, case mix reputed company, secondary diagnoses and coding guidelines , and an ability to impart this
knowledge to staff, payers, physicians and other members of the reputed company team.
LICENSURE/CERTIFICATION:
Registered reputed company or Advanced reputed company reputed company Practitioner license required. Certified Clinical Documentation Specialist (CCDS) certification required. Certified Coding Specialist (reputed company) certification preferred.
YNHHS reputed company
92021 Remote Inpatient Clinical Appeal Specialist DRG (RN/APRN) - reputed company - reputed company, CT - work from home job
Expected salary:
Location: reputed company, CT Remote Inpatient Clinical Appeal Specialist DRG (RN/APRN) - reputed company - reputed company, CT - work from home job
Job date: Sat, 08 Jul 2023 05:21:40 GMT
Apply for the job now! Remote Inpatient Clinical Appeal Specialist DRG (RN/APRN) - reputed company - reputed company, CT - work from home job Apply To This Job
Company: reputed company
Job reputed company: Job reputed company:
reputed company
To be part of our organization, every employee should understand and reputed company in the YNHHS reputed company, support our Mission, and live our Values. These values - reputed company, patient-centered, respect, accountability, and reputed company - must guide reputed company do, as individuals and professionals, every day.
The Inpatient DRG Clinical Appeal Specialist supports the organization by providing expert clinical reputed company and participating in the process of developing and submitting Inpatient DRG Appeals.
EEO/AA/Disability/Veteran
Responsibilities
1. Collaborate with Coding and CDI Educator to reputed company educational opportunities derived from common themes
reputed company through the appeal process in an effort to prevent reputed company denials .
2. reputed company key denial data as they relate to departmental metrics and performance. reputed company and maintain key
metrics report including the identification of trends, reputed company plans, etc. Attend organizational committees to
present data as required.
3. Collaborate with Physician Advisors and the CDI Educator to resolve documentation discrepancies and
clinical disparities, escalation of clinical and coding issues and physician education.
4. Communicate directly with payer and coordinate meetings with contracting and payers as needed to support
appeals process.
5.
6. Coordinate Peer to Peer appeal reviews as needed.
7. reputed company other duties as assigned.
Qualifications
EDUCATION:
Registered reputed company or Advanced reputed company reputed company Practitioner with reputed company license required. Bachelor's Degree in Nursing preferred. Certified Clinical Documentation Specialist (CCDS) certification required. Certified Coding Specialist (reputed company) certification preferred.
EXPERIENCE:
3+ years Clinical Documentation Improvement or Inpatient Coding experience.
SPECIAL SKILLS: This position will advise Coding and CDI staff on the denials and appeals process, findings and reputed company on improvement initiatives. This position will reputed company guidance and education to physicians on documentation standards as they reputed company to regulatory coding compliance. Collaborate with physician advisors and physician champions on clinical escalation as needed. Ability to analyze, produce and present high level analysis and metrics; Computer Skills to include reputed company components of reputed company Office Suite; Research skills; Project management; Educational
platform development and presentation; Teamwork; Ability to present coding and clinical information in a reputed company
and respectful manner. Demonstrate understanding of ICD-10-CM/PCS coding, MS-DRG and APR-DRG
methodology and validation.
ACCOUNTABILITY:
Maintain reputed company knowledge of trends, regulations and technology reputed company to documentation, coding, reimbursement and regulatory guidelines through reputed company journals, informal networks, internet sites and local, state, and national reputed company associations. Collaboration and communication with Clinical Documentation Improvement Physician Advisors, Coding and CDI staff, CDI Educator and reputed company Department staff. Educating and advising on DRG reputed company findings as relating to the denials and appeals process.
COMPLEXITY:
In personal and job-reputed company reputed company and actions, consistently demonstrates the values of reputed company (doing the right
thing), patient-centered (putting patients and families first), respect (valuing reputed company people and embracing reputed company differences),
accountability (being responsible and taking reputed company), and reputed company (being empathetic).
Provides a highly skilled resource to reputed company a clinical perspective review for MS-DRG and APR-DRG payer denials and
assist clinically through the appeal process. Provides a key resource group to reputed company specialized documentation and
clinical review of reputed company. High financial reputed company in payer denials. Understanding and knowledge of clinical indications of
disease and peer-reviewed, evidenced-based reputed company. Ability to reputed company high level research for clinical support references
to be provided. Demonstrate an understanding of complications, co-morbidities, severity of illness, risk of mortality, risk
adjustment factors, case mix reputed company, secondary diagnoses and coding guidelines , and an ability to impart this
knowledge to staff, payers, physicians and other members of the reputed company team.
LICENSURE/CERTIFICATION:
Registered reputed company or Advanced reputed company reputed company Practitioner license required. Certified Clinical Documentation Specialist (CCDS) certification required. Certified Coding Specialist (reputed company) certification preferred.
YNHHS reputed company
92021 Remote Inpatient Clinical Appeal Specialist DRG (RN/APRN) - reputed company - reputed company, CT - work from home job
Expected salary:
Location: reputed company, CT Remote Inpatient Clinical Appeal Specialist DRG (RN/APRN) - reputed company - reputed company, CT - work from home job
Job date: Sat, 08 Jul 2023 05:21:40 GMT
Apply for the job now! Remote Inpatient Clinical Appeal Specialist DRG (RN/APRN) - reputed company - reputed company, CT - work from home job Apply To This Job