Inpatient DRG Coding Auditor

Title: Inpatient DRG Coding Auditor

Location: US-GA-Atlanta

Work Type: Remote, Full Time

Job ID: 164511

Hourly Minimum

USD $39.31/Hr.

 Hourly Midpoint

USD $47.90/Hr.

Job Description:

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!

Work Location: REMOTE

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

MINIMUM QUALIFICATIONS:

• Certified Coding Specialist (CCS) certification.
• RHIA/RHIT preferred.
• 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.

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.