Inpatient DRG Coding Auditor

This is a fully remote position, open to applicants in Alabama, +13 more states.

📋 Description

• Examine inpatient medical records for specified payer populations after discharge and before billing.

• Assess the precision and thoroughness of diagnosis and procedure coding, DRG assignments, and abstracted data including Present on Admission (POA) and Discharge Disposition.

• Identify variations between the Clinical Documentation Specialist (CDS) DRG and the Coder DRG.

• Evaluate non-CC/MCC records to ascertain if they were incorrectly coded or if further documentation is necessary.

• Collaborate with Coders and CDSs to develop and initiate physician queries.

• Conduct reviews promptly to uphold the DNFB target of 4 days.

• Organize educational and training sessions on technical coding and clinical subjects for coding personnel.

• Oversee remediation when it is needed.

• Partner with Coding leadership, Quality nurses, and the CDS team to educate physicians, nursing staff, and other clinical personnel to enhance documentation.

• Review DRG Reassignment letters and assist in crafting Appeal letters.

⛳️ Requirements

• High school diploma.

• At least five (5) years of experience with ICD-10 coding in an acute care environment.

• Prior experience conducting DRG coding audits.

• Certified Coding Specialist (CCS) certification.

• Understanding of DRG and grouping methodologies (MS DRGs and AP DRGs), especially regarding diagnoses/procedures that influence DRG assignment.

• Basic computer proficiency in word processing and spreadsheet applications.

• Strong interpersonal skills to cultivate necessary relationships for facilitation and education.

• Excellent prioritization and organizational abilities.

• Candidates must be physically located and authorized to work in Alabama, Arkansas, Florida, Georgia, Illinois, Louisiana, Michigan, New Hampshire, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, or Wisconsin.

• Capability to fulfill the specified physical and environmental requirements, including the use of personal protective equipment where applicable.

🏝️ Benefits

• Comprehensive health benefits that commence on day one.

• Student Loan Repayment Assistance & Reimbursement Programs.

• Family-oriented benefits.

• Wellness incentives.

• Continuous mentorship, development, and leadership programs.