Inpatient DRG Coding Auditor

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JOB DESCRIPTION:

• 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.
• Reviews DRG Reassignment letters and assists in formulating Appeal letters

Minimum Required Qualifications:

• Education: High school diploma Experience: Minimum five (5) years experience with coding ICD-10 in an acute care setting. Previous experience in performing DRG coding audits.
• Certification: Certified Coding Specialist (CCS) certification. Skills: 1. Possesses knowledge of DRG and grouping methodologies (MS DRGs and AP DRGs); in particular what diagnoses / procedures impact DRG assignment. 2. Basic computer skills in word processing and spreadsheet utilization. 3. Excellent interpersonal skills to develop relationships necessary to facilitate and educate. 4. Excellent prioritization and organizational skills. Preferred Qualifications: Education: Bachelors degree in related field Certification: RHIA/RHIT.
  
  PHYSICAL REQUIREMENTS (Medium): 20-50 lbs; 0-33% of the work day (occasionally); 11-25 lbs 34-66% of the workday (frequently); 01-10 lbs 67-100% of the workday (constantly); Lifting 50 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking Occasional sitting Close eye work (computers typing reading writing) Physical demands may vary depending on assigned work area and work tasks.
  
  ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock Floor Surfaces Hot/Cold Temperatures Indoor/Outdoor conditions Latex Lighting Patient care/handling injuries Radiation Shift work Travel may be required. Use of personal protective equipment including respirators environmental conditions may vary depending on assigned work area and work tasks.

Emory is an equal opportunity employer and qualified applicants will receive consideration for employment without regard to race color religion sex national origin disability protected veteran status or other characteristics protected by state or federal law.

Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcares Human Resources at . Please note that one weeks advance notice is preferred.