Remote - Inpatient DRG Coding Auditor

Emory Healthcare; United States; Remote; USD 80,000 - 110,000; Full time

Job summary

Emory Healthcare is hiring a Clinical Documentation Specialist to review inpatient records post-discharge, audit DRG assignments, and coordinate with coders to ensure accurate billing. The role emphasizes collaboration with CDS teams, education of staff, and timely query initiation to maintain DNFB metrics.

The position supports remote work from specific U.S. states and requires CCS certification, with five years of ICD-10 coding experience in acute care.

Qualifications

• Education: High school diploma and five years ICD-10 coding in acute care.
• CCS certification required; knowledge of DRG methodologies (MS-DRG/AP-DRG).
• Strong interpersonal, prioritization, and organizational skills.
• Basic computer skills for word processing and spreadsheets.

Responsibilities

• Review inpatient medical records for payer populations post-discharge and pre-bill.
• Audit accuracy of diagnosis, procedures, DRG assignment, and POA.
• Collaborate with Coders and CDSs to draft physician queries.
• Provide coding education and coordinate remediation with Coding leadership and CDS team.

Skills

DRG coding

Interpersonal skills

MS Word / Excel

Time management

Coding accuracy

Education

High school diploma

Bachelor's degree in related field

RHIA/RHIT certification (preferred)

Certified Coding Specialist (CCS)

Tools

Microsoft Word

Microsoft Excel

Job description

Overview

Be inspired. Be valued. Belong. At Emory Healthcare

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. We provide:

• 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; however, applicants must be physically located and authorized to work in one of the following states: Alabama, Arkansas, Florida, Georgia, Illinois, Louisiana, Michigan, New Hamsphire, North Carolina, Ohio, Pennsylavnia, South Caroline, Tennessee, Texas, Virginia, Wisconsin

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 contact Emory Healthcare's Human Resources at [e-mail]. Please note that one week's advance notice is preferred.