Inpatient DRG Coding Auditor

Inpatient Drg Coding Auditor

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Job 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.
• Reviews 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.

Additional Details

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 Healthcare's Human Resources at View email address on click.appcast.io. Please note that one week's advance notice is preferred.