Reviewer

• Review inpatient claims imported into the DRG database, focusing on diagnosis, procedures, grouping logic, and reimbursement accuracy.
• Analyze weekly hospital billing files, identifying underpaid claims based on ICD-10 diagnosis and procedure codes.
• Conduct detailed medical record reviews post-bill to determine if submitted diagnosis and procedure codes are accurate and complete.
• Navigate medical records efficiently, targeting specific sections (e.g., discharge summary, operative reports) based on system edits and flagged items.
• Match clinical documentation in the medical record to corresponding ICD-10 codes, ensuring DRG accuracy.
• Identify and correct errors such as under coded or misclassified diagnoses and procedures.
• Utilize Health ROI system edits to detect specific high-value opportunities (e.g., dialysis, occlusion, embolization, catheterization).
• Make reimbursement improvement recommendations and submit findings for client review and approval.
• Collaborate with leadership on case prioritization and workflow management.
• Stay informed on coding updates, payer guidelines, and DRG changes to support accurate recommendations.
• Analyze client reporting.
• Identify new revenue opportunities related to all inpatient DRG related components.

DRG Validator/Reviewer analyzing inpatient claims for reimbursement accuracy.

DRG Validator/Reviewer

DRG Validator/Reviewer responsible for reviewing post-billed inpatient claims for missed reimbursement opportunities. Utilizes ICD-10 coding expertise to optimize hospital reimbursement while ensuring compliance.

• Use rubrics and supplemental information to provide fair and consistent evaluations with encouraging, specific, and actionable feedback
• Maintain an in-depth knowledge of every component of curriculum within assigned workload
• Swiftly respond to student outreach and return evaluations to students within 48 hours of submission
• Work with Goal Lead to provide proactive outreach to students in need of academic assistance
• Participate in Reviewer online community
• Support academic integrity validation and processing potential violations
• Participate in quality assurance processes and project improvement activities, as needed

Reviewer evaluating student projects at Southern New Hampshire University

Reviewer responsible for evaluating student project submissions at Southern New Hampshire University. Provide actionable feedback and ensure academic integrity in evaluations.

• In-person interview may be required during the hiring process
• Manage relationships with internal and external customers/vendors

MD Appraisal Reviewer managing automobile appraisals at Mercury Insurance

MD Appraisal Reviewer

MD Appraisal Reviewer managing automobile appraisals at Mercury Insurance. Collaborating with internal and external teams to ensure efficient processes and accurate valuations.

• Title Review for states in our legal footprint
• Highlighting specific experience in Title Review and Title Curative matters
• Managing multiple tasks and prioritizing effectively
• Communicating title issues within a client case management platform
• Analyzing title documents and legal descriptions of the property
• Navigating and researching online county records
• Maintaining production levels on a daily basis
• Comfortable working independently and as part of a team

Title Reviewer managing title documents in legal cases for legal firm

Foreclosure Title Reviewer

Title Reviewer managing title documents for legal firm McMichael Taylor Gray, LLC in Tennessee. Responsible for analyzing legal property descriptions and communicating title issues effectively.

Reviewer jobs in Tennessee

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DRG Validator/Reviewer

Reviewer

MD Appraisal Reviewer

Foreclosure Title Reviewer