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Inpatient DRG Auditor
Location: Arizona, Remote
Work Setting: Hospital, Other
Job Function: Auditor
Job Type: Full-Time
HonorHealth is a non-profit, local community healthcare system serving an area of 1.6 million people in the greater Phoenix area. The network encompasses five acute-care hospitals, an extensive medical group, outpatient surgery centers, a cancer care network, clinical research, medical education, a foundation and community services
Inpatient DRG Auditor (This is a remote opportunity, but must reside in Arizona)
The DRG Auditor is responsible for performing an in-depth review of select inpatient medical records to ensure that the assigned codes and DRG are supported by clinical documentation and all diagnoses and procedures are coded with the required specificity and the discharge disposition and the POA are correct Knowledge of IPPS methodology is required. Responsible for mentoring and training other coders. Provide ongoing feedback and education to coding staff and Clinical Documentation Specialists.
Responsible for researching new technology for accurate code assignment. Assign and sequence ICD-10-CM, ICD-10-PCS, CPT and HCPCs diagnostic and procedural codes for all inpatient records for data retrieval, billing, and reimbursement. Perform documentation assessment and review for accurate abstracting of clinical data to meet regulatory and compliance requirements. Assist management with assigned special projects.
- Assigns and sequences ICD-10-CM, ICD-10/-PCS, CPT and HCPCs diagnostic and procedural codes for inpatient and/or outpatient accounts within HonorHealth. Reviews physician documentation & coding for appropriateness & accuracy and makes corrections following Medicare & AMA coding guidelines. Assigns DRG and performs DRG validation as applicable. Reviews and provides coding guidance to coding staff. Utilizes electronic medical record and computer-assisted coding (CAC) software. Addresses NCCI, OCE, LCD, and other applicable coding edits.
- Complies with system-wide coding practices to meet corporate compliance guidelines and to ensure appropriate and effective reimbursement with Patient Financial Services, medical staff and various departments. Reviews and analyzes medical records for accurate ICD and CPT code selection.
- Mentors and educates coding staff and providers to ensure timely notification of identified trends that might impact revenue or compliance. Educates assigned providers on appropriate coding and documentation and provide supporting documentation to enhance awareness and corrections needed for accurate coding.
- Participates in special projects involving coding, payer testing, and other project that interface with coding. Assists Patient Financial Services with interpretation and selection of appropriate ICD/CPT codes and /or other information requested for accurate billing and reimbursement. Possesses knowledge and understanding of failed bill parameters.
- Performs charge reconciliation to ensure all submitted charges are posted timely and balance with total submitted charges. Assigns charges as applicable.
- Communicates with hospital and outside agencies to reconcile issues affecting the coding department, including denials, coding errors, guideline clarifications, and technical issues. Addresses coding questions from coders and other entities. Resolves coding issues/problems and appropriately seeks assistance from Coding Supervisor.
- Creates and updates information in shared coding drive as applicable, and communicates updates/change to applicable staff. Participates in continuing education activities to enhance knowledge, skills and keep credentials current in order to maintain skill set for outpatient coding.
- High School Diploma or GED
- CCS, RHIT, or RHIA certification
- 3 years inpatient coding experience
- Non ClinicalCCS – Certified Coding Specialist CCS (Certified Coding Specialist) or
CIC (Certified Inpatient Coder) or
CPC-H/COC (Certified Outpatient Coder) Upon Hire
- Tuition assistance up to $5,250* per year
- Comprehensive medical, dental and vision insurance with domestic partner coverage
- 403(b) retirement savings plan that provides immediate vesting and dollar-dollar match up to 4%
- On-site child and elder care centers
- Employee assistance program
- Free parking, discounted bus passes, fitness facilities and much more!
*terms and conditions apply
HonorHealth System Overview:
- Six acute-care hospitals
- Three Level I trauma centers
- 15 Virginia G. Piper Cancer Care Network locations
- 12,000 employees
- Medical group with 70+ primary, specialty and urgent care locations
- 500+ ongoing clinical trials and studies at the HonorHealth Research Institute
- System-wide, fully integrated Epic EMR
- Five Magnet® recognized hospitals
- Four intensive care units that are recipients of the Beacon Award for Excellence from the American Association of Critical Care Nurses
- Recognized by Becker’s Hospital Review, 150 Top Places to Work in Healthcare 2019
- Recognized by Forbes, Best Employers 2017, 2018, 2019 and 2020
- All HonorHealth Medical Centers achieved B or higher rating in the spring 2019 The Leapfrog Hospital Safety Grades
It is the policy of HonorHealth to provide equal opportunity in employment. Selection and employment of applicants will be made on the basis of their qualifications without regard to race, color, religion, creed, national origin, age, disability, sexual orientation, marital status, veteran status or any other legally protected status.
Instructions for Resume Submission
For immediate consideration, please apply online:
Or email your resume to Robin Ersland: firstname.lastname@example.org
Apply Online: https://jobs.honorhealth.com/jobs/34302?lang=en-us
Posted: April 28, 2021 at 12:49 PM
Post ID: 60417