Coding Auditor - DRG/APC Coordinator

University of Chicago Medicine•Chicago, IL

5d•Remote

About The Position

Be a part of a world-class academic healthcare system at UChicago Medicine as a Coding Auditor - DRG/APC Coordinator for the Health Information Management department. This is a remote, work from home opportunity and you may be based outside of the greater Chicagoland area. In this role, the Coding Auditor - DRG/APC Coordinator is responsible for ensuring accuracy and quality of coding assignments for all records requiring DRG and/or APC coding, and ensures optimal and timely reimbursement. Essential Job Functions Performs data quality reviews on inpatient and outpatient records to ensure proper coding guidelines have been followed and appropriate DRG or APC assignments have been made for appropriate reimbursement Provides DRG/APC and coding quality information and statistical reports to the Coding Manager Communicates with the Medical Staff and House staff as needed to discuss clinical questions with respect to the assignment of ICD-10-CM and ICD-10-PCS codes for diagnoses and procedures Educates the Medical Staff and House staff regarding the importance of sufficient documentation to support the assignment of the appropriate DRG/APC Reviews Hospitals' specific coding guidelines and procedures and suggests changes and updates to the Coding Manager Participates in team meetings with coding personnel to discuss coding problems, changes, or issues Performs routine coding and abstracting as directed Utilizes 3M encoder optimizing function to review data for accuracy Reviews PRO coding changes, reports findings to the Coding Manager, and - provides appropriate documentation to the PRO when appealing a PRO decision Maintains accreditation with AHIMA and abides by the Standards of Ethical Coding as set forth by the AHIMA Remains current on all PRO, OIG and IPPS/OPPS rules and regulations, coding updates, changes and issues

Requirements

A bachelor's degree from an accredited academic body or in lieu of a completed degree; equivalent experience
Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA), and Certified Coding Specialist (CCS) credentials
Four (4) years coding experience with a minimum of two (2) years PPS coding, DRG grouping, & APC payment experience
Five (5) years of inpatient facility coding experience with at least two (2) years in an academic setting
Working knowledge of 3M HDM Abstracting System and 3M Codefinder /DRG finder; must have working knowledge of JCAHO standards for chart completion
Working knowledge of medico-legal rules and regulations that govern the confidentiality and release of medical information with the ability to interpret and implement the standards; must maintain total confidentiality of all patient records
Data entry skills
Must comply with UChicago Medicine’s COVID-19 Vaccination requirement as a condition of employment. If you have already received the vaccination, you must provide proof as part of the pre-employment process. This is in addition to your compliance with the Flu Vaccination requirement as well. Medical and religious exemptions will be considered consistent with applicable law. Lastly, a pre-employment physical, drug screening, and background check are also required for all employees prior to hire.

Responsibilities

Performs data quality reviews on inpatient and outpatient records to ensure proper coding guidelines have been followed and appropriate DRG or APC assignments have been made for appropriate reimbursement
Provides DRG/APC and coding quality information and statistical reports to the Coding Manager
Communicates with the Medical Staff and House staff as needed to discuss clinical questions with respect to the assignment of ICD-10-CM and ICD-10-PCS codes for diagnoses and procedures
Educates the Medical Staff and House staff regarding the importance of sufficient documentation to support the assignment of the appropriate DRG/APC
Reviews Hospitals' specific coding guidelines and procedures and suggests changes and updates to the Coding Manager
Participates in team meetings with coding personnel to discuss coding problems, changes, or issues
Performs routine coding and abstracting as directed
Utilizes 3M encoder optimizing function to review data for accuracy
Reviews PRO coding changes, reports findings to the Coding Manager, and - provides appropriate documentation to the PRO when appealing a PRO decision
Maintains accreditation with AHIMA and abides by the Standards of Ethical Coding as set forth by the AHIMA
Remains current on all PRO, OIG and IPPS/OPPS rules and regulations, coding updates, changes and issues