Inpatient DRG Coding Auditor - Emory Healthcare

At Emory Healthcare, we integrate science and caring to change the face of health care. Our team members are courageous individuals who are willing to challenge the status quo and help find solutions to complex problems. We’re empowered to influence change for, and with, our patients, their families, the community and each other.

As one of the leading academic medical systems, we’re eager to share what we learn with hospitals around the country, and the world. We’ve got the backing, knowledge, experience and permission to lead the way in developing new and better approaches to preventing and treating disease, and our patients get treatments years before anyone else.

We’re defining a new standard of care for humankind. Are YOU ready to join us?

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.
• 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.

Salary: $28.87 - $50.02/hour

The grade and salary of the position are based on specific criteria met within the qualifications of relevant experience, skills, performance and internal equity.