DRG Coordinator Coding
Company: Society for Vascular Ultrasound
Posted on: January 16, 2023
The DRG Coordinator coding is responsible for ensuring
efficiency in inpatient coded and abstracted data collection to
optimize DRG reimbursement with direct reflection in the Case Mix
Index (CMI) calculation while complying with federal, state, and
payer-specific regulations and policies pertaining to
documentation, coding and billing. This position utilizes
continuous improvement principles to support Coding processes and
functions with direct impact on the BSCHS Revenue Cycle activities
and outcomes. Responsibilities:
- Develops a collaborative CDMP team in order to maintain a
positive open communication environment with physicians,
interdisciplinary care team members and department managers.
- Facilitates appropriate clinical documentation to ensure
medical records are accurate and recommends
improvements/documentation guidance to the CDMP and medical staff
- Develops and conducts ongoing clinical documentation management
education for all new staff, including new clinical documentation
specialists, physicians, nursing and allied health
- Educates all internal and external customers on clinical
documentation opportunities, coding and reimbursement issues as
well as performance improvement methodologies.
- Reviews clinical issues with the coding staff to assign as
working DRG, resolve discrepancies in the final DRG and provides
ongoing feedback to the CDMP staff.
- Develops initiatives to support CDMP strategies and
opportunities while setting goals to manage financial and material
resources. Participates in system wide initiatives especially VBP,
SOI, ROM, and ICD 10.
- Coordinates the BSCHS ICD-10 Coding Training Program.
- Assists in the developing ICD-10 Physician Documentation
Improvement Programs and ensures compliance with ICD-10 coding
guidelines related to the BSCHS Revenue Cycle activity.
- Develops reports, collects and prepares data for studies
involving inpatient stays for clinical evaluation purposes and
financial impact and profitability.
- Initiates corrective actions to ensure resolution of problem
areas identified during an internal investigation or
- Performs periodic claim form reviews to check code transfer
accuracy from the abstracting system and the CDM.
- Evaluates records and responds to the Quality Improvement
Organization (QIO) DRG change and denial notices.
- Supports Accounts Receivable management best practices by
providing coding expertise in inpatient/outpatient claims
- Participates in budget preparation as requested. Performs other
duties as assigned. Qualifications/Requirements: Requires minimum
of five (5) years of progressive coding (inpatient and outpatient)
or coding review experience in ICD-10-CM and CPT-4, DRG/APC
optimization with claims processing. Inpatient PCS competency
required. ICD-10 Certified Trainer and data management
responsibilities a plus. Proficient user of Coding and Abstracting
Information Systems and data reporting applications. Previous
experience in an electronic medical record environment (EPIC) and
Computer Assisted Coding Applications, with strong ad hoc reporting
capabilities preferred. Certified Coding Specialist (CCS) coding
certification from the American Health Information Management
Association (AHIMA) required. Knowledge of disease process as well
as anatomy and physiology. Education: Bachelor's degree, required.
Other: If applicable, the individual performing this job may
reasonably anticipate coming into contact with human blood and
other potentially infectious materials. Individuals in this
position are required to exercise universal precautions, use
personal protective equipment and devices, and learn the policies
concerning infection control. About Us: Good Samaritan Hospital
Good Samaritan Hospital in Suffern, NY, is a 286-bed hospital
providing emergency, medical, surgical, obstetrical/gynecological
and acute-care services to residents of Rockland and southern
Orange counties in New York; and northern Bergen County, NJ. The
hospital is home to a recognized cardiovascular program,
comprehensive cancer-treatment services, the area's leading Wound
and Hyperbaric Institute and outstanding maternal/child services
that includes a Children's Diagnostic Center. Good Samaritan
Hospital also provides social, psychiatric and substance-abuse
services and its certified home-care agency supports residents of
the Hudson Valley and beyond.
Keywords: Society for Vascular Ultrasound, Montebello , DRG Coordinator Coding, Other , Montebello, California
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