Remote DRG Validator
Description
Remote DRG Validator
Job Responsibilities:
Perform remote review of selected inpatient discharges from Client’s editing program for DRG validation purposes utilizing Client’s encoder software, clinical information system, and abstracting system
Perform a comprehensive review of the inpatient discharges to confirm:
Correct principal diagnosis selection and to check if co-existing diagnoses exist during the time of the admission
Appropriate secondary diagnoses including, but not limited to, complications, co-morbidities, and major CC’s
Correct procedure code(s) selection
Proper sequencing
Accuracy of Hospital-Acquired Condition (HAC) code
The severity of Illness (SOI) and Risk of Mortality (ROM) classification validation
Present On Admission (POA) indicator
Correct discharge status
Potential for conditions relative to Patient Safety Indicators (PSI)
Perform the review based on AHA Coding Clinic for ICD-10-CM guidelines, CMS ICD-10-CM and ICD-10-PCS Official Guidelines for Coding and Reporting, and Uniform Hospital Discharge Data Set definitions
Assess if the clinical documentation supports the diagnoses and procedure codes reported
Enter coding changes found into the internal database tracking system
Release all change discharges in Client’s abstracting system and/or DRG editing system
Display a positive attitude within the organization in support of the organization’s programs and mission
Promotes effective working relations and works effectively as part of a department/unit team to facilitate goals and objectives
Maintains confidentiality of all hospital and patient information
Requirements
Education and Experience:
High School diploma or equivalent
RHIA, RHIT, CCS or CPC credential required
3 – 5 years’ of inpatient coding and DRG validation experience in an acute care setting
Skills and Abilities:
Extensive knowledge of AHA coding guidelines and ICD-10-CM/PCS coding system
Knowledge of MS-DRG and NYS-APR grouper logic, and CMS regulations is required
Strong analytical and communication skills with attention to detail
Ability to work independently under minimal supervision
PC proficient, having a functional knowledge of facility EMR, encoder, and other support software
Compensation and Benefits:
Competitive; commensurate with experience
Medical/Dental/Vision
Life Insurance
401K Plan
Paid Time Off (PTO)
Pay: $18.00 - $35.00 per hour
Apply To Become A Medical Coding Agent:
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Please contact us directly to discuss remote medical coding job openings at 405-494-0214.
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Skills
Extensive knowledge of AHA coding guidelines and ICD-10-CM/PCS coding system
Knowledge of MS-DRG and NYS-APR grouper logic, and CMS regulations is required
Strong analytical and communication skills with attention to detail
Ability to work independently under minimal supervision
PC proficient, having a functional knowledge of facility EMR, encoder, and other support software