DRG Nurse Auditor

Join Access Healthcare Manila as a DRG Nurse Auditor. We are seeking talented individuals to join our team and help drive our success.Apply now and take the next step in your career today. We will provide free training on the client's medical billing software to perform this role.Tasks:Conduct initial audit reviews to validate billed diagnoses and DRG code...

The Auditor, Coding Quality conducts Initial Coding Quality Reviews (IQRs), Monthly Coding Quality Reviews (MQRs), Focused Quality Audits, and other ad hoc coding quality audits as requested to ensure hospital inpatient, outpatient , and profee claims, ICD-10-CM/PCS, and/or CPT codes were coded and billed in accordance with nationally recognized coding...

Job Profile Summary:Responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims.Primary duties may include, but are not limited to:Analyzes and audits claims by integrating medical chart coding principles,...

Job Description:The Auditor, Coding Quality conducts Initial Coding Quality Reviews (IQRs), Monthly Coding Quality Reviews (MQRs), Focused Quality Audits, and other ad hoc coding quality audits as requested to ensure hospital inpatient, outpatient , and profee claims, ICD-10-CM/PCS, and/or CPT codes were coded and billed in accordance with nationally...

Benefits:20 Paid Time Off (PTO) per yearAnnual AppraisalAnnual Performance Based IncentiveWeekends offHMO plus 2 FREE dependentsGroup life insurancePosition Summary:The CDI Physician Reviewer is responsible for improving overall quality and completeness of clinical documentation to accurately reflect patient severity of illness and risk of mortality through...

Benefits:20 Paid Time Off (PTO) per yearAnnual AppraisalPerformance Based IncentiveWeekends offHMO with FREE DependentsGroup life insurancePosition Summary:The CDI Physician Reviewer is responsible for improving overall quality and completeness of clinical documentation to accurately reflect patient severity of illness and risk of mortality through extensive...

Responsible for the accurate review/audit of medical claims based defined claims guidelines and policies.Review claims or modifies existing claims according to the appropriate and applicable actionAnalyze claims to determine appropriate action to approve or deny action done by the agentDetermine if accurate payment criteria for clearing pending claims based...

3 OpeningsTaguigRole descriptionResponsible for the accurate review/audit of medical claims based defined claims guidelines and policies.Review claims or modifies existing claims according to the appropriate and applicable actionAnalyze claims to determine appropriate action to approve or deny action done by the agentDetermine if accurate payment criteria...

Senior Manager - Enterprise Control Management, Regulatory & Audit Exam Management#4th in Great Place to Work's Best Company To Work For 2025#10th in Fortune Magazine's 2025 World's Most Admired Companies#1st in the J.D. Power 2024 U.S. Credit Card Satisfaction Study of National Credit Card IssuersTop GBS Employers for the Philippines by the Everest GroupAt...

Overview Hybrid - Taguig | 5-10 Yrs Exp | Bachelor | Full-time Job title: ICU RN Auditor Work set-up: Hybrid in Taguig Work shift: Mid-shift Job Description We are seeking a detail-oriented and experienced ICU RN Auditor to review and assess medical records, coding accuracy, and documentation compliance in intensive care unit (ICU) settings. The ideal...

The Auditor, Coding Quality conducts Initial Coding Quality Reviews (IQRs), Monthly Coding Quality Reviews (MQRs), Focused Quality Audits, and other ad hoc coding quality audits as requested to ensure hospital inpatient, outpatient , and profee claims, ICD-10-CM/PCS, and/or CPT codes were coded and billed in accordance with nationally recognized coding...

Sr. Recruitment Analyst | Psychometrician Job Description: The Auditor, Coding Quality conducts Initial Coding Quality Reviews (IQRs), Monthly Coding Quality Reviews (MQRs), Focused Quality Audits, and other ad hoc coding quality audits as requested to ensure hospital inpatient, outpatient , and profee claims, ICD-10-CM/PCS, and/or CPT codes were coded and...

Outpatient Coding Quality Auditor Conifer Health Solutions is seeking the Auditor, Coding Quality to conduct Initial Coding Quality Reviews (IQRs), Monthly Coding Quality Reviews (MQRs), Focused Quality Audits, and other ad hoc coding quality audits as requested to ensure hospital inpatient, outpatient, and profee claims, ICD-10-CM/PCS, and/or CPT codes were...

Overview Inpatient Coding Quality Auditor role at Conifer Health Solutions. The Auditor, Coding Quality conducts Initial Coding Quality Reviews (IQRs), Monthly Coding Quality Reviews (MQRs), Focused Quality Audits, and other ad hoc coding quality audits to ensure hospital inpatient, outpatient, and profee claims, ICD-10-CM/PCS, and/or CPT codes are coded and...

Overview The Auditor, Coding Quality conducts Initial Coding Quality Reviews (IQRs), Monthly Coding Quality Reviews (MQRs), Focused Quality Audits, and other ad hoc coding quality audits as requested to ensure hospital inpatient, outpatient, and profee claims, ICD-10-CM/PCS, and/or CPT codes were coded and billed in accordance with nationally recognized...

Overview Experienced USRN – Emergency, OR, Surgical Ward, or ICU Nurse | 100K Sign-On Bonus Job Openings Experienced USRN – Emergency, OR, Surgical Ward, or ICU Nurse | 100K Sign-On Bonus About the job Experienced USRN – Emergency, OR, Surgical Ward, or ICU Nurse | 100K Sign-On Bonus Requirements Active PHRN and USRN License USRN License (Any...

Overview Join to apply for the Prior Authorization Nurse - PHRN (QA) role at HR TechX Corp. Position: Clinical/Prior Authorization - Quality Auditor Qualifications Must hold an active PHRN license (not a USRN license holder) Must have at least solid 4 to 7 years experience in Clinical/Prior Authorization or Utilization Review Relevant experience as a Quality...

About the job Prior Authorization Nurse - PHRN (QA) Position: Clinical/Prior Authorization - Quality Auditor Qualifications: Must hold an active PHRN license (not a USRN license holder) Must have at least solid 4 to 7 years experience in Clinical/Prior Authorization or Utilization Review Relevant experience as a Quality Auditor in Clinical Services...

Prior Authorization Specialist (PHRN - Registered Nurse) Job openings: Prior Authorization Specialist (PHRN - Registered Nurse) About the job Prior Authorization Specialist (PHRN - Registered Nurse) We are seeking a detail-oriented and organized Prior Authorization Specialist to join our healthcare team. In this role, you will be responsible for obtaining...