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Be a part of a world-class academic healthcare system at UChicago Medicine as a DRG/APC Coordinator - Coding Auditor for the Health Information Management department. In this role, the DRG/APC Coordinator- Coding Auditor is responsible for ensuring accuracy and quality of coding assignments for all records requiring DRG and/or APC coding; insures optimal and timely reimbursement.
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Utilizes technical coding principals and/or MS-DRG/APR-DRG reimbursement expertise to assign appropriate ICD-10 Diagnoses/Procedures. One of the following: Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA.
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When symptoms in the medical record require further documentation, the CDI Specialist queries the physician for a specific diagnosis/procedure for more accurate DRG coding. The CDI Specialist is the primary source to verify diagnoses in the medical record for proper DRG coding.
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Is a division of Davey Resource Group (DRG), has been employee owned since 1979. is a division of Davey Resource Group (DRG), has been employee owned since 1979. Davey Resource Group, Inc., is a leader in the natural resource, environmental, and forestry consulting industries throughout the United States.
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Maintains an up-to-date working knowledge of MS-DRG, APR-DRG, ICD-10 CM/PCS coding. Expert knowledge of Official Coding Guidelines, advanced knowledge of APR and MS DRG reimbursement models, state, and federal regulations.
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Minimum 2 years code/DRG auditing experience preferred. Health information management and/or coding credential from AHIMA and/or AAPC required (RHIA, RHIT, CCS, and/or CIC) Solid command of anatomy, physiology, pathology, laboratory, imaging, pharmacology, disease assessment, patient management, and treatment.
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Knowledge of AHRQ Quality Metrics including patient safety indicators (PSIs), Hospital Acquired Conditions (HACs), Vizient Mortality Models, CMS Core Measures, other national patient safety quality indicators, and different payor categories.
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Concurrent reviews assure the completeness of medical records, the accuracy of documentation, and the appropriate assignment of a final DRG. The CDI Specialist functions as a resource for clinical staff and other groups involved in the care and discharge planning of patients.
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Clinical license preferred (e.g., LPN, RN, BSN, NP, PA, MD, DO, allied health) CCDS or CDIP certification preferred. The Quality Assurance (QA) Specialist is responsible for performance of internal coding QA reviews.
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Ability to provide guidance and training to Accuity coding, physician, and CDI staff. Knowledge of legal, regulatory, and policy compliance issues related to medical coding and documentation. Experience with electronic health records and health information systems as well as different encoders.
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Advanced knowledge of medical coding, electronic medical record systems, and coding systems. Knowledge of current and developing issues and trends in medical coding diagnosis and procedure code assignment.
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Ability to clearly communicate information to coders, physicians, and CDI staff. Review scope includes validation of the MS-DRGs and APR-DRGs assigned for Medicare, Medicaid, commercial, and third-party claims.
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Independent, focused individual able to work remotely or on-site. These reviews provide an additional layer of internal coding quality and compliance of inpatient (IP) records to assure appropriateness and accuracy of code assignments in accordance with official coding guidelines and client facility specific coding guidelines.
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Maintains turnaround time expectations to minimize impact to client DNFB. Minimum 5 years of hospital inpatient coding and/or inpatient clinical documentation improvement experience required. Performs IP coding quality assurance (QA) reviews.
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Knowledge of quality assurance/healthcare internal auditing concepts and principles. Independent, focused individual who takes initiative and can work remotely. Demonstrated knowledge of all applicable coding clinics as they relate to current IP coding practices.
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