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
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
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 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.
I have worked with DRG Claims Management for many years in two different health plans.
What really impresses me is their professionalism and scope of knowledge and particularly the ability to work so cooperatively with our hospital providers to see a case through as long as necessary to confirmed resolution.
They bring superior results with essentially little to no burden placed on health plan resources.
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 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.