Remote Inpatient DRG Coding Auditor

Emory Healthcare; Alpharetta (GA); Remote; USD 90,000 - 120,000; Full time

Job summary

Emory Healthcare is seeking a skilled Clinical Documentation Specialist/Code reviewer to audit inpatient records, ensure accurate ICD-10 coding and DRG assignments, and collaborate with CDSs and coders. The role emphasizes accuracy, timely reviews, and education to improve documentation.

The position involves cross-functional coordination to educate clinicians and support DRG integrity and appeals processes. Remote work options available for qualified candidates located in designated states.

Qualifications

• Education: High school diploma.
• Experience: Minimum five (5) years experience with ICD-10 in an acute care setting.
• Certification: CCS certification.
• Knowledge: DRG methodologies (MS DRG's and AP DRG's) and impact on DRG assignment.
• Computer: Basic word processing and spreadsheet skills.
• Interpersonal: Excellent interpersonal, prioritization and organizational skills.

Responsibilities

• Review inpatient medical records for selected payer populations post-discharge and pre-bill; audit diagnosis, procedure coding, DRG assignment, and abstracted data.
• Review discrepancies between CDS DRG and the coder DRG; determine if records were miscoded or need more documentation.
• Draft and initiate physician queries with Coders and CDSs; ensure timely reviews to meet targets.
• Coordinate educational programs for coding staff and coordinate remediation as needed.
• Educate physicians and staff to improve documentation; assist in DRG reassignment letters and appeals.

Skills

DRG knowledge

Interpersonal skills

Prioritization

Computer skills

Education

High school diploma

Bachelor's degree (preferred)

Job description

Emory Healthcare is seeking a skilled Clinical Documentation Specialist/Code reviewer to audit inpatient records, ensure accurate ICD-10 coding and DRG assignments, and collaborate with CDSs and coders. The role emphasizes accuracy, timely reviews, and education to improve documentation.

The position involves cross-functional coordination to educate clinicians and support DRG integrity and appeals processes. Remote work options available for qualified candidates located in designated states.