Job Summary
A health services company needs applicants for an opening for a Remote Diagnosis Related Group Validation Follow-up Manager.
Core Responsibilities of this position include:
- Auditing and reviewing Medicare and non-Medicare charts to ensure that proper DRG standards are maintained
- Reviewing denied cases by using pre-established criteria and determines if an appeal to the denial is warranted
- Meeting with Revenue Cycle leaders to review and problem-solve DRG related payment discrepancies
Applicants must meet the following qualifications:
- 4 year/ Bachelor's Degree
- 3-5 years’ experience within Hospital-based Revenue Cycle, preferably experience with denials follow-up and management
- Knowledge of claims processing for various insurances both private and governed
- Ability to look at an account and determine a plan of action for collection
- Ability to comprehend tools provided for securing payment, and apply them to differing accounts to result in payment
