Coding Auditor - DRG/APC Coordinator

Job Description

Be a part of a world-class academic healthcare system at UChicago Medicine as a Coding Auditor - DRG/APC Coordinator for the Health Information Management department. This is a remote, work from home opportunity and you may be based outside of the greater Chicagoland area.

In this role, the Coding Auditor - DRG/APC Coordinator is responsible for ensuring accuracy and quality of coding assignments for all records requiring DRG and/or APC coding, and ensures optimal and timely reimbursement.

Essential Job Functions

• Performs data quality reviews on inpatient and outpatient records to ensure proper coding guidelines have been followed and appropriate DRG or APC assignments have been made for appropriate reimbursement
• Provides DRG/APC and coding quality information and statistical reports to the Coding Manager
• Communicates with the Medical Staff and House staff as needed to discuss clinical questions with respect to the assignment of ICD-10-CM and ICD-10-PCS codes for diagnoses and procedures
• Educates the Medical Staff and House staff regarding the importance of sufficient documentation to support the assignment of the appropriate DRG/APC
• Reviews Hospitals' specific coding guidelines and procedures and suggests changes and updates to the Coding Manager
• Participates in team meetings with coding personnel to discuss coding problems, changes, or issues
• Performs routine coding and abstracting as directed
• Utilizes 3M encoder optimizing function to review data for accuracy
• Reviews PRO coding changes, reports findings to the Coding Manager, and - provides appropriate documentation to the PRO when appealing a PRO decision
• Maintains accreditation with AHIMA and abides by the Standards of Ethical Coding as set forth by the AHIMA
• Remains current on all PRO, OIG and IPPS/OPPS rules and regulations, coding updates, changes and issues

Required Qualifications

• A bachelor's degree from an accredited academic body or in lieu of a completed degree; equivalent experience
• Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA), and Certified Coding Specialist (CCS) credentials
• Four (4) years coding experience with a minimum of two (2) years PPS coding, DRG grouping, & APC payment experience
• Five (5) years of inpatient facility coding experience
• Working knowledge of 3M HDM Abstracting System and 3M Codefinder/DRG finder; must have working knowledge of JCAHO standards for chart completion
• Working knowledge of medico-legal rules and regulations that govern the confidentiality and release of medical information with the ability to interpret and implement the standards; must maintain total confidentiality of all patient records
• Data entry skills

Position Details:

• Job Type/FTE: Full Time
• Shift: Days
• Location: Remote
• Unit/Department: Health Information Management
• CBA Code: Non-Union