Inpatient DRG Validator & Coding Analyst

Essential Duties and Responsibilities

• Ability to read, decipher and analyze all aspects of medical record documentation for accurate coding.
• Responsible for reviewing inpatient coding (ICD-10-CM and ICD-10-PCS codes) to ensure accuracy and completeness of records coded by the coding staff for multiple clients.
• Validate the ICD-10-CM and PCS codes, principal and secondary diagnoses
• Assignment appropriateness to ensure consistency and efficiency and to optimize DRG reimbursement and facilitate data quality in hospital inpatient services.
• Review physician documentation for specificity, completeness, and quality to support coding accuracy, and to identify physician query opportunities to improve the documentation.
• Maintains current knowledge of regulatory agencies standards, i.e., CMS, OIG, AHA, Coding Clinics etc.
• Maintain required coding credential(s)
• Seeks opportunities for individual growth and development, including attending various meetings, conferences, and courses, as required,
• Responsible for meeting departmental productivity and quality expectations.
• Consult with client organizations and their department heads at the direction of the service line director.
• Collaborate with other service line team members to meet client demands and to develop strategies for service line growth and operational improvement.

Required Qualifications

• A minimum, 5+ years’ experience with Coding IP Claims
• CCS (Certified Coding Specialist) credential required
• Experience with Medicare and Medicaid DRGs.
• Experience with DRG Validator.
• Experience with OP coding a plus.
• Strong coding knowledge and follow the official coding rules, guidelines, and conventions to validate coded data and ensure high quality and compliance with regulatory requirements.
• Demonstrates competency in the use of computer applications in the EHR (i.e., Cerner, EPIC, Meditech, etc.) and knowledge in DRG grouping software.
• Computer proficiency as related to MS Office and in-house proprietary software.
• Demonstrates knowledge in hospital/healthcare settings such as revenue cycle, coding, and reimbursement.
• Knowledge of ICD-10-CM/PCS required
• ICD-10-CM/PCS AHIMA Approved Trainer experience highly desired.
• Excellent oral and written communication skills, including the ability to interact with high-level of management.
• Detailed-oriented and able to meet targeted deadlines.
• Bachelor of Science degree in a related field, Associates in Health Information Technology minimally acceptable
• RHIA or RHIT a plus, CCS credential required.