Remote - Inpatient DRG Coding Auditor

Emory Healthcare; Alpharetta (GA); A distancia; USD 90.000 - 120.000; Jornada completa

Descripción de la vacante

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.

Formación

• 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.

Responsabilidades

• 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.

Conocimientos

DRG knowledge

Interpersonal skills

Prioritization

Computer skills

Educación

High school diploma

Bachelor's degree (preferred)

Descripción del empleo

Emory HealthcareBe inspired. Be valued. Belong. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be.

• Comprehensive health benefits that start day 1
• Student Loan Repayment Assistance & Reimbursement Programs
• Family-focused benefits
• Wellness incentives
• Ongoing mentorship, development, leadership programs
• And more

LOCATION: Remote

This position is remote; however, applicants must be physically located and authorized to work in one of the following states: Alabama, Arkansas, Florida, Georgia, Illinois, Louisiana, Michigan, New Hampshire, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Wisconsin

Job Description

JOB DESCRIPTION: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. Review's DRG Reassignment letters and assists in formulating Appeal letters

Minimum Required Qualifications

Education: High school diploma Experience: Minimum five (5) years experience with coding ICD-10 in an acute care setting. Previous experience in performing DRG coding audits. Certification: Certified Coding Specialist (CCS) certification. Skills: 1. Possesses knowledge of DRG and grouping methodologies (MS DRG's and AP DRG's); in particular what diagnoses / procedures impact DRG assignment. 2. Basic computer skills in word processing and spreadsheet utilization. 3. Excellent interpersonal skills to develop relationships necessary to facilitate and educate. 4. Excellent prioritization and organizational skills.

Preferred Qualifications

Education: Bachelor's degree in related field Certification: RHIA/RHIT.

PHYSICAL REQUIREMENTS

(Medium): 20-50 lbs; 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 50 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.

ENVIRONMENTAL FACTORS

Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock, Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation, Shift work, Travel may be required. Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.

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 note that one week's advance notice is preferred.