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Emory Healthcare/Emory University DRG Coding Auditor - EDH in Decatur, Georgia

Overview

Work Hours: Full-time

100% Remote Worker, may be required to pay Georgia and current resident state taxes.

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.

  • Assists in development and coordination of educational and training programs regarding technical coding and clinical topics for the coding staff.

  • Assists with development and implementation in coordination with the Coding Manager, Quality nurses and the CDS team to educate physician, nursing, and other clinical staff to improve documentation.

  • Review DRG Reassignment letters and assists in formulating Appeal letters.

MINIMUM QUALIFICATIONS:

  • Certified Coding Specialist (CCS) certification. RHIA/RHIT preferred.

  • Minimum five (5) years experience with coding ICD-10 in an acute care setting.

  • Previous experience in performing DRG coding audits.

  • Possesses knowledge of DRG and grouping methodologies (MS DRG and AP DRG); in particular what diagnoses / procedures impact DRG assignment.

  • Basic computer skills in word processing and spreadsheet utilization.

  • Excellent interpersonal skills to develop relationships necessary to facilitate and educate.

  • Excellent prioritization and organizational skills.

PHYSICAL REQUIREMENTS (Medium Max 25lbs): up to 25 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 25 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.

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Division Emory Decatur Hospital

Campus Location Decatur, GA, 30033

Campus Location US-GA-Decatur

Department CORP-Medical Records

Job Type Regular Full-Time

Job Number 74211

Job Category Revenue Cycle & Managed Care

Schedule Other

Standard Hours 40 Hours

Emory Healthcare is an Equal Employment Opportunity employer committed to providing equal opportunity in all of its employment practices and decisions. Emory Healthcare prohibits discrimination, harassment, and retaliation in employment based on race, color, religion, national origin, sex, sexual orientation, gender identity or expression, pregnancy, age (40 and over), disability, citizenship, genetic information, service in the uniformed services, veteran status or any other classification protected by applicable federal, state, or local law.

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