Inpatient DRG Coding Auditor
About The Position
Overview Be inspired. Be valued. Belong. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, leadership programs...and more! Description We are seeking an experienced Inpatient DRG Coding Auditor to extract data from patient encounters ensuring the accuracy of DRGs. This individual will: Reviews inpatient medical records for select payer populations post-discharge and pre-bill; audits the accuracy and completeness of diagnosis and procedure coding, DRG assignment, and abstracted data POA, Discharge Disposition. Reviews discrepancies between the Clinical Documentation Specialist (CDS) DRG and the Coder DRG. Reviews non-CC/MCC records to determine if record was miscoded or if additional documentation is needed. Works with Coders and CDSs to draft and initiate physician queries. Performs reviews in a timely manner to maintain DNFB target of 4 days. Provides Coding development with coordination of educational and training programs regarding technical coding and clinical topics for the coding staff. Coordinates remediation when required. Coordinates with the Coding leadership, Quality nurses and the CDS team to educate physicians, nursing, and other clinical staff to improve documentation. Review¿s DRG Reassignment letters and assists in formulating Appeal letters
Requirements
- Certified Coding Specialist (CCS) certification.
- Minimum five (5) years experience with coding ICD-10 in an acute care setting.
- Previous experience in performing DRG coding audits.
- Possesses knowledge of DRG and grouping methodologies (MS DRG's and AP DRG's); in particular what diagnoses / procedures impact DRG assignment.
- Basic computer skills in word processing and spreadsheet utilization.
- Excellent interpersonal skills to develop relationships necessary to facilitate and educate.
- Excellent prioritization and organizational skills.
Nice To Haves
- RHIA/RHIT preferred.
Responsibilities
- Reviews inpatient medical records for select payer populations post-discharge and pre-bill; audits the accuracy and completeness of diagnosis and procedure coding, DRG assignment, and abstracted data POA, Discharge Disposition.
- Reviews discrepancies between the Clinical Documentation Specialist (CDS) DRG and the Coder DRG.
- Reviews non-CC/MCC records to determine if record was miscoded or if additional documentation is needed.
- Works with Coders and CDSs to draft and initiate physician queries.
- Performs reviews in a timely manner to maintain DNFB target of 4 days.
- Provides Coding development with coordination of educational and training programs regarding technical coding and clinical topics for the coding staff.
- Coordinates remediation when required.
- Coordinates with the Coding leadership, Quality nurses and the CDS team to educate physicians, nursing, and other clinical staff to improve documentation.
- Review¿s DRG Reassignment letters and assists in formulating Appeal letters
Benefits
- Comprehensive health benefits that start day 1
- Student Loan Repayment Assistance & Reimbursement Programs
- Family-focused benefits
- Wellness incentives
- Ongoing mentorship, development, leadership programs
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
Number of Employees
5,001-10,000 employees
