Clinical/DRG validation Specialist
4 weeks ago
We are recruiting experienced, certified senior Clinical/DRG Validation Specialists with extensive knowledge of ICD-10-CM and PCS coding, current proficiency in coding clinics, and excellent communication skills.
Qualifications:
Minimum of 2-4 years of experience in Clinical Validations and at least 5 years in Inpatient Facility coding.
Education: Life Sciences Graduate or Postgraduate.
Credentials: Must possess active AHIMA/AAPC certification(s).
Communication: Outstanding verbal and written proficiency in English.
Work Location: Must be ready to work from the Hyderabad office.
Responsibilities:
Ability to appeal clinically denied diagnoses using clinical and coding guidelines without missing due dates.
Involvement in the clinical denial/appeal process for DRG challenges and clinical validations through Clinical Validation Audits.
Reviewing payer denials, determining if an appeal is justified, and writing appeals.
Ensuring accurate code assignment by thoroughly understanding coding conventions, guidelines, and updates.
Experience in reading and comprehending medical records.
Conducting clinical validation by reviewing physician documentation to ensure correct codes and sequencing are applied to claims.
Accurately depicting the clinical scenario within the constructs of the ICD-10-CM/PCS code set.
Understanding and validating the appropriateness of services rendered, ensuring that documented conditions meet reportable claims data requirements.
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Clinical/DRG validation Specialist
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Delhi, Delhi, India Doctususa Inc Full timeClinical/DRG Validation SpecialistWe are recruiting experienced, certified senior Clinical/DRG Validation Specialists with extensive knowledge of ICD-10-CM and PCS coding, current proficiency in coding clinics, and excellent communication skills.Qualifications:Minimum of 2-4 years of experience inClinical Validationsand at least 5 years inInpatient Facility...
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Clinical/DRG validation Specialist
1 week ago
Delhi, Delhi, India Doctususa Inc Full timeClinical/DRG Validation SpecialistWe are recruiting experienced, certified senior Clinical/DRG Validation Specialists with extensive knowledge of ICD-10-CM and PCS coding, current proficiency in coding clinics, and excellent communication skillsQualifications:Minimum of 2-4 years of experience in Clinical Validations and at least 5 years in Inpatient...
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