Southeast Georgia Health System is in the heart of Georgia's Golden Isles, renowned for gentle breezes, grand oak trees, the sound of the surf, and our prized, ecology-rich Marshes as described by Sidney Lanier in the poem, "The Marshes of Glynn."
DRG Validator
Location
United States
Posted
1 day ago
Salary
0
Seniority
Mid Level
No structured requirement data.
Job Description
DRG Validator
SGHS
Role Description The DRG Validator ensures the accurate assignment of Diagnosis Related Groups (DRGs) for our patients and applies a thorough understanding of medical coding guidelines, clinical documentation, and reimbursement principles. All team members of Southeast Georgia Health System will promote a culture of safety, follow established policies, and adhere to all state and federal regulatory requirements, Joint Commission requirements, and national patient safety standards. For our team members, this is more than a career — it’s a calling. - Reviews medical records and clinical documentation to verify the accuracy of assigned DRGs to ensure the correct case mix is reflected for our Health System. - Analyzes patient charts to identify discrepancies or inconsistencies in DRG assignment. - Stays updated on changes in coding guidelines, regulations, and healthcare policies affecting DRG assignment. - Demonstrates understanding of policies, procedures and federal guidelines that apply directly to coding, DRG assignment, reimbursement, clinical documentation improvement, and UB 04 standards. - Responsible for reviewing clinical documentation reviews performed for all inpatients prior to billing within the requirements of the Centers of Medicaid & Medicare Services and other regulatory agencies. - Collaborates with coding and clinical staff to resolve coding-related issues. - Participates in coding audits and quality improvement initiatives. - Effectively communicates current and revised coding changes and clarifications to ancillary departments and Medical Staff members. - Works with Quality team as needed. - Performs second review of focus DRG’s, discharge disposition, and Present on Admission flags of encounters prior to billing. Qualifications - College Degree in Health Information Management or related field - 5 years’ Inpatient coding experience - Credentialed coding professional, RHIA, RHIT, CCS, CPC CCS-P required Benefits - Competitive pay - Generous Paid-time-off accrual - 403B retirement savings with company match - Medical/dental/vision insurance coverage - Employee-assistance program - Tuition reimbursement - Legal services plan Company Description Southeast Georgia Health System is in the heart of Georgia's Golden Isles, renowned for gentle breezes, grand oak trees, the sound of the surf, and our prized, ecology-rich Marshes as described by Sidney Lanier in the poem, "The Marshes of Glynn."
Related Guides
Related Categories
Related Job Pages
More Analyst Jobs
• Operate and evolve CRM campaigns in Braze using Canvas, Campaigns, Segmentation, Content Cards and Connected Content, with end-to-end ownership from setup to activation. • Plan, create and optimize automated journeys and lifecycle rules, focusing on customer lifecycle, behavior and business objectives. • Develop and maintain advanced segmentations using attributes, events, behavioral filters and conditional logic. • Execute multichannel campaigns (email, push notifications, in-app, SMS, WhatsApp and web push), ensuring orchestration across channels and a consistent user experience. • Implement dynamic content personalization using Liquid, custom attributes and display logic. • Conduct A/B tests and experiments, defining hypotheses, success metrics and result analyses. • Perform technical and functional QA of campaigns and journeys, ensuring quality, governance and reducing rework. • Monitor and analyze CRM KPIs (engagement, conversion, retention, churn, LTV), generating actionable insights. • Proactively resolve technical and operational issues in Braze, collaborating with data, product and engineering teams. • Contribute to the evolution of CRM strategy by proposing improvements to flows, business rules and communication approaches. • Support documentation of processes, best practices and campaign standards. • Ensure compliance with LGPD (Brazilian Data Protection Law), consent requirements and privacy policies, safeguarding data governance and security. •
• Monitor and track applicable legislation; • Submission of municipal, state, and federal statutory filings and ancillary obligations; • Respond to municipal, state, and federal tax audits and inspections; • Analyze direct and indirect taxes; • Calculation of taxes for standard tax regimes (Presumed Profit - Lucro Presumido and Actual Profit - Lucro Real); • Preparation and analysis of trial balances and company financial statements; • Control, verification, and recording of information to ensure compliance with applicable legislation; • Use of Excel as a support tool; • Provide assistance and take responsibility for accounting queries and practices; • Consolidation of managerial and asset-related transactions.
Role Description The IT Budget Analyst will provide research and analytical support to the IT-Non-IT Workgroup (ITW) within the Veterans Health Administration (VHA). This role is critical in facilitating the IT and non-IT-related initiatives by offering comprehensive research, analysis, and report preparation for decision-making. The IT Budget Analyst will work closely with various stakeholders to ensure the accurate delivery of project goals by supporting funded and unfunded IT/non-IT initiatives within VHA. This individual will engage in frequent interaction with VHA IT governance bodies and play a pivotal role in ensuring the success of key projects. - Data Collection and Analysis: Conduct in-depth research to gather data relevant to IT and non-IT projects. Analyze complex datasets to generate actionable insights and recommendations. - Reporting: Prepare and present detailed reports, briefing materials, and updates for ITW leads, stakeholders, and VHA executive leadership. Maintain precise documentation to support strategic decisions. - Project Support: Assist with the development of project plans, schedules, deliverables, and key performance indicators (KPIs) for various initiatives within ITW. - Meeting Coordination: Organize and provide logistical support for ITW meetings and briefings, ensuring proper communication with stakeholders. - Documentation Management: Maintain documentation of research findings, project updates, and meeting minutes, ensuring accessibility and traceability of project artifacts. - Support for IT/Non-IT Initiatives: Facilitate the progression of both IT and non-IT projects, ensuring alignment with VHA's strategic objectives and adherence to governance processes. Qualifications - Bachelor's degree in research, Data Analytics, Information Technology, Healthcare Management, or a related field. - At least 3 years of experience in research and data analysis, preferably within the healthcare or government sector. - Must have prior acquisition and budget experience with a federal agency. - Strong analytical, problem-solving, and decision-making abilities. - Proven capability to translate data into insights that support strategic decisions. - Proficiency with Microsoft Office Suite, particularly Excel, PowerPoint, and data analysis tools. - Excellent written and verbal communication skills with experience presenting to leadership. Requirements - Familiarity with IT and non-IT project funding processes within the VHA or other federal institutions. - Knowledge of the New Service Request (NSR) and Multi-Year Programming (MYP) processes. - Previous appropriation law experience. Benefits - Health Care Plan (Medical, Dental & Vision) - Retirement Plan (401k, IRA) - Life Insurance (Basic, Voluntary & AD&D) - Paid Time Off (Vacation, Sick & Public Holidays) - Short Term & Long Term Disability - Training & Development
Education and Development Analyst
Center for Health Care StrategiesBetter care where it's needed most
• Provide ongoing Quality Assurance for CBO Business Service associates • Conduct quality reviews and report evaluations to the team supervisor • Provide ongoing development and maintenance of training materials • Act as a resource and answer questions to all team members • Assist team in reviewing and processing daily work • Work closely with all teams under Business Services for efficient workflows • Responsible for obtaining and maintaining policies and procedures • Compile information and prepare reports to monitor team goals and results • Test, implement, and train associates on materials related to Epic Upgrade • Identify, analyze and report any credit trends to management team • Cross-trained in workflows of other teams for reporting and training purposes • Assist respective team and other teams with daily duties as assigned



