Posting Job Title Coding Auditor - DRG/APC Coordinator

University of Chicago Medical Center; United (PA); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading academic healthcare provider is seeking a Coding Auditor - DRG/APC Coordinator. This remote position involves ensuring the accuracy of coding assignments and educating medical staff on proper documentation practices. The ideal candidate should have a relevant degree, coding certifications, and several years of coding experience, particularly in an academic setting.

Qualifications

• Four years of coding experience with two years in PPS coding, DRG grouping, and APC payment.
• Five years of inpatient facility coding experience with two years in an academic setting.
• Working knowledge of JCAHO standards for chart completion.

Responsibilities

• Perform data quality reviews on inpatient and outpatient records.
• Provide DRG/APC and coding quality information to the Coding Manager.
• Educate medical staff regarding documentation support for DRG/APC assignments.

Skills

Data quality reviews

Communication with medical staff

Coding accuracy

Documentation practices

Knowledge of medico-legal rules

Data entry skills

Education

Bachelor's degree or equivalent experience

Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA)

Certified Coding Specialist (CCS)

Tools

3M HDM Abstracting System

3M Codefinder/DRG finder

Job description

Be a part of a world-class academic healthcare system at UChicago Medicine as a Coding Auditor - DRG/APC Coordinator for the Health Information Management department. This is a remote, work from home opportunity and you may be based outside of the greater Chicagoland area.

In this role, the Coding Auditor - DRG/APC Coordinator is responsible for ensuring accuracy and quality of coding assignments for all records requiring DRG and/or APC coding, and ensures optimal and timely reimbursement.

Essential Job Functions

• Performs data quality reviews on inpatient and outpatient records to ensure proper coding guidelines have been followed and appropriate DRG or APC assignments have been made for appropriate reimbursement
• Provides DRG/APC and coding quality information and statistical reports to the Coding Manager
• Communicates with the Medical Staff and House staff as needed to discuss clinical questions with respect to the assignment of ICD-10-CM and ICD-10-PCS codes for diagnoses and procedures
• Educates the Medical Staff and House staff regarding the importance of sufficient documentation to support the assignment of the appropriate DRG/APC
• Reviews Hospitals' specific coding guidelines and procedures and suggests changes and updates to the Coding Manager
• Participates in team meetings with coding personnel to discuss coding problems, changes, or issues
• Performs routine coding and abstracting as directed
• Utilizes 3M encoder optimizing function to review data for accuracy
• Reviews PRO coding changes, reports findings to the Coding Manager, and provides appropriate documentation to the PRO when appealing a PRO decision
• Maintains accreditation with AHIMA and abides by the Standards of Ethical Coding as set forth by the AHIMA
• Remains current on all PRO, OIG and IPPS/OPPS rules and regulations, coding updates, changes and issues

Required Qualifications

• A bachelor's degree from an accredited academic body or in lieu of a completed degree; equivalent experience
• Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA), and Certified Coding Specialist (CCS) credentials
• Four (4) years coding experience with a minimum of two (2) years PPS coding, DRG grouping, & APC payment experience
• Five (5) years of inpatient facility coding experience with at least two (2) years in an academic setting
• Working knowledge of 3M HDM Abstracting System and 3M Codefinder/DRG finder; must have working knowledge of JCAHO standards for chart completion
• Working knowledge of medico-legal rules and regulations that govern the confidentiality and release of medical information with the ability to interpret and implement the standards; must maintain total confidentiality of all patient records
• Data entry skills

Position Details:

• Job Type/FTE: Full Time
• Shift: Days
• Location: Remote
• Unit/Department: Health Information Management
• CBA Code: Non-Union

Equal Opportunity Employer

UChicago Medicine is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, ethnicity, ancestry, sex, sexual orientation, gender identity, marital status, civil union status, parental status, religion, national origin, age, disability, veteran status and other legally protected characteristics.