Inpatient DRG Auditor & Coding Quality Specialist

Grady-Health-System; Atlanta (GA); Presencial; USD 70 000 - 100 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Health benefits

Tuition reimbursement

Paid time off

Resumo da oferta

Grady Health System in Atlanta is seeking a DRG Validator to review inpatient coded records per UHDDS definitions, validate diagnoses and procedures, and ensure correct DRG assignments using MS-DRG/APR-DRG guidelines. The role collaborates with Quality, CDI, and coding teams to ensure accurate reimbursements.

The position supports chart reviews, presents concise audit rationales, and may perform inpatient coding tasks as needed, leveraging Epic and SMART tools within a high‑reliability

Qualificações

• 2 years auditing experience or strong training in coding and reimbursement.
• 5 years progressive inpatient coding in an acute care hospital with ICD-10-CM/PCS experience.
• Experience with Epic System and coding standards (AHIMA/CODING clinics) is a plus.

Responsabilidades

• Performs daily coding reviews for HACs, PSIs, and focused DRGs on inpatient records identified by SMART.
• Notify Quality Department for Quality Level reviews when PSI/HAC and POA indicators align with documentation.
• Review records to validate secondary diagnoses and procedures for compliance with reporting requirements.
• Write concise rationale to support audit findings and DRG review letters with appropriate guidelines.
• Evaluate clinical documentation quality to identify incomplete or ambiguous documentation impacting DRG assignment and reimbursement.
• Use SMART Tool for data analysis to identify coding trends and opportunities for improvement.
• Collaborate with CDI Manager for pre-bill review of Mortality charts and HACs; assist with inpatient coding as needed.
• Coordinate with Coding Vendor and HIM leadership to develop educational improvements based on audit findings.

Conhecimentos

Auditing

MS-DRG

APR-DRG

POA Guidelines

Coding Guidelines

Data Analysis

Formação académica

BA Health Administration

Ferramentas

Epic System

SMART Tool

Descrição da oferta de emprego

Grady Health System in Atlanta is seeking a DRG Validator to review inpatient coded records per UHDDS definitions, validate diagnoses and procedures, and ensure correct DRG assignments using MS-DRG/APR-DRG guidelines. The role collaborates with Quality, CDI, and coding teams to ensure accurate reimbursements.

The position supports chart reviews, presents concise audit rationales, and may perform inpatient coding tasks as needed, leveraging Epic and SMART tools within a high‑reliability