We do more so you pay less

DRG claims management is an industry-leading validation and recovery solutions provider serving the interests of healthcare plans across the nation.

See How

You won’t settle for industry standards and neither do we

Not too big to care

Our rise to the top of the industry was built off the back of our humble roots. We believe that plans shouldn’t be forced to choose between corporate professionalism and personal service in claims management

Because at DRG
every client
is the only one that matters

We are the company of choice for insurers who demand payment integrity

Fraud

Waste

Abuse

Carelessness

Pay your share - Not more

Who We Are

Decades of first-rate expertise

In this complex and detailed-oriented world, we offer the thing that matters most: experience in every facet of the clinical, billing, and auditing processes

Meet the team

Katreece Baker, CCS

VP Clinical Operations

Katreece has 25+ years of experience in the Healthcare Industry. Her experience began in frontline physician practices gaining payer methodology knowledge to appropriate coding principles to accounts receivable reconciliation mastery. With her focus on coding shifting to the hospital setting, she developed advantageous management skills becoming a Coding Manager, Director of HIM, and Corporate Director of HIM, auditing inpatient and outpatient coding in those positions before specializing in Auditing and Client Management.

She has extensive experience and knowledge in MS-DRG and APR-DRG coding and auditing, performing quality assurance, outpatient auditing, and deriving payer payment calculations. She is fluent in identifying claims with potential recovery. She has also served as a successful Client Manager for Medicare, Medicaid, and Commercial payers, working hand in hand to troubleshoot issues, to identity coding and billing regulations, and to answer questions to accomplish prosperous solutions for all parties involved.

Bernie Klein

CEO

Bernie Klein is an innovative presence in the medical billing arena boasting a number of successful business endeavors and a host of pioneering products brought to market.

Bernie began his career just as the healthcare industry was undergoing significant changes after the passage of the ACA (Affordable Care Act). His first foray into the world of DME billing was crowned with great success, and he then set his sights on a venture he named DRG Claims Management.

What Bernie found in the field of DRG auditing convinced him that there’s a lot of work to be done from an efficiency and results standpoint, and he rolled up his sleeves together with a team of experts to develop innovative auditing solutions. Among them was the idea of pre-payment auditing which was at first encountered with resistance and logistical stumbles, but eventually succeeded in saving on his clients’ bottom line and streamlining the process significantly for all parties.

Bernie and his team have also developed smart, automated tools that sift through large numbers of claims and identify targets that are most likely to result in successful recoveries and reimbursements. He has led his firm’s growth by applying his superb managerial skills to build a cohesive and motivated team that expects excellence throughout and is committed to remaining a step ahead of the field.

Bernie brings a holistic, forward-thinking approach to every endeavor, combining talent, skill, organization and focus to complete every mission in a superior and most efficient manner. With one eye always focused on the future, he continues to set new standards and reach new heights in this complex, yet rewarding arena.

Tom Martin, PMP, CSPO, AIMP

AVP Client Relations

Tom Martin has worked in education and healthcare, the latter for 20 years. Tom’s focus has largely been with Payment Integrity (PI) with COB/Subrogation, Post-payment data-mining, Pre-Payment editing, Claims Audit, DRG & Medical Record Audits, and Vendor Stacking.

In these roles, Tom worked within health plans as the PI lead to set up PI shops and consulted as a PI SME, both domestically and internationally, to assist clients with PI challenges. Tom received a BA in Corporate Communication, a MBA, and a MA in Adult Education. In his role at DRG, Tom educates and challenges clients and presents to other groups who could benefit from auditing services.

Josh Korman MD, MBA

Chief Strategy and Revenue Growth Officer

Josh Korman is a seasoned healthcare operations professional with over a decade of leadership experience. Currently, as the Chief Strategy and Revenue Growth Officer at DRG Claims Management, he has boosted revenue and operational efficiency through strategic initiatives and automation.

Previously, as Director of Health Plan Relationships and Director of Operations at DRG Claims Management, Josh led integration projects and improved operational processes. At NYC Health + Hospitals, he enhanced quality and compliance as Assistant Director of Quality & Performance Improvement Operations.

Josh holds an MBA from the University of Illinois Urbana-Champaign and an MD from St. Matthew's School of Medicine. His expertise in strategic planning and operational excellence drives his commitment to improving patient care.

Abraham Kaufman

Chief Information Officer

Abraham is a proven technology leader with many years of experience leading and defining technology solutions for companies from the retail, telecommunications and health industries. His success is attributable to knowing how to adapt to rapidly changing environments and to building IT organizations that strive for operational excellence and innovative solutions.

As Chief Information Officer of DRG Claims Management, Abraham leads technology strategy development and execution. Abraham is also conducting the programs, policies, and procedures to ensure that we are fully compliant with HIPPA and all federal and state requirements.

Dawn Fagerness, RHIA, CCS, CPC, PMP

Director of Auditing

Dawn has over 30 years of healthcare industry experience, with a focus in healthcare insurance. She has a wide range of experience in DRG/claims auditing and utilization management.

Her career has included conducting medical claims review to determine medical necessity of inpatient hospital claims and retrospective medical review of appeals. She has many years of experience performing DRG/APR-DRG validation of hospital claims, retrospectively reviewing inpatient hospital records to determine appropriate reimbursement.

She has successfully managed multiple complex projects and personnel for a variety of clients, including Medicare Advantage, Medicaid and Commercial payors.

Katreece Baker, CCS
AVP of Clinical Operations
Bernie Klein
CEO
Tom Martin, PMP, CSPO, AIMP
AVP Client Relations
Josh Korman MD, MBA
Director of Operations
Abraham Kaufman
Chief Information & Security Officer
Dawn Fagerness, RHIA, CCS, CPC, PMP
Director of Auditing