DRG Validator -Coding Department - Remote- Days

JOB DESCRIPTION

Location: Atlanta, GA

Schedule : FTE

Sign On : $5,000

DRG Validator

JOB SUMMARY

The DRG Validator, is responsible for reviewing medical records in accordance with UHDDS Definitions to validate an inpatient admit order, assignment of and sequencing of ICD-10-CM/PCS principal and secondary diagnoses, principal and secondary procedures, the discharge disposition codes and the DRG Assignment. All HACs, PSIs and focused MS-DRGs are identified by the PWC SMART Application. Collaborates with Quality Department for 2nd Level quality review of all Hospital Acquired Conditions (HACs) and selected AHRQ Patient Safety Indicators (PSIs). This position will require a Solid knowledge of MS-DRG, APR-DRG (SOI/ROM), Coding Guidelines, American Hospital Association (AHA) Coding Clinic and Present on Admission (POA) Indicator Guidelines.

QUALIFICATIONS

• BA or BS in a Healthcare. Formal HIM education with national certification (RHIA, RHIT). Coding certification (CCS) required from AHIMA.
• Five (5) years progressive coding in an acute care facility and coding review experience in ICD-10-CM/PCS. Past auditing experience or a strong training background in coding and reimbursement, preferred.

• RHIA or RHIT and CCS, required.

o Certified Clinical Documentation Specialist (CCDS), a plus

o Certified Documentation Improvement Practitioner (CDIP), a plus

• Good oral and written communication skills and comprehensive knowledge of the MS_DRG structure and regulatory requirements.
• Knowledge of 3M Encoder/Computer Assisted Coding (CAC) and Epic EMR. Prior knowledge of PWC SMART Application, a plus.
• Extensive working knowledge of Medicare, Medicaid and Commercial Provider reimbursement methodologies to assist Patient Financial Services when needed.

Equal Opportunity Employer-Minorities/Females/Veterans/Individuals with Disabilities/Sexual Orientation/Gender Identity.