DRG Validation / Team CoachAccuity Delivery Systems
About The Company:
Accuity Delivery Systems was founded in 2016 with the goal of reinventing the Clinical Documentation Process through MD case review, and MD to MD education. Over the last two years, we have experienced rapid growth as a company and are excited to continue in growing our team of health information professionals.
About The Position:
Under direct supervision from the EVP of Coding, the DRG Team Coach reviews medical records with a Physician Leader and a Clinical Documentation Improvement specialist (CDIS) as needed. The DRG Team Coach reviews the record in accordance of federal coding regulations and guidelines as well as client specific coding guidelines as the record pertains to appropriate DRG assignment. The DRG Team Coach uses knowledge of Accuity Delivery Systems (ACCDS) technology and client systems and procedures to provide a second level review of codes assigned to medical diagnoses and clinical procedures that ensure accurate DRG assignment. Additionally, the DRG Team Coach provides regular feedback to ACCDS coding staff.
Primary Job Responsibilities:
- Reviews medical record documentation to determine appropriate DRG assignment by identifying those diagnosis and procedure codes that support the DRG assigned.
- Utilizes ACCDS technology for tracking of coding errors, query opportunities and other data collection as needed.
- Provides individual and group education and training on accurate coding practices.
- Researches, analyzes, and responds to inquiries regarding compliance, inappropriate coding, and denials.
- Interacts with ACCDS physicians, Coders, and CDIS regarding documentation, policies, procedures, and regulations.
- Trains, instructs, and/or provides technical support to ACCDS physicians, coders, and CDIS as appropriate regarding coding compliance documentation, and regulatory provisions.
- Reviews, develops, modifies, and/or adapts relevant client procedures, protocols, and systems to coordinate with ACCDS methodology.
- Interacts with management on an ongoing basis
- Ensures strict confidentiality of patient medical records.
- Attends in-house training sessions to receive updated coding information and changes in coding and/or regulations.
- Codes medical records as needed based on organizational needs.
- High School Diploma or GED Required
- Associates Degree in Health Information Management or similar preferred
- Minimum 5 years of inpatient coding experience in hospital facility coding
- ICD-10 experience required
- Minimum 5 years experience that is directly related to the duties and responsibilities specified above.
- Experience and knowledge in DRG reimbursement (I.e., MS-DRG, APR-DRG)
- Coding credential required from AHIMA (RHIA, RHIT, and/orCCS)
Knowledge, Skills, and Abilities:
- Knowledge of auditing concepts and principles.
- Working knowledge of coding guidelines
- Ability to use independent judgment and to manage and impart confidential information.
- Advanced knowledge of medical coding, electronic medical record systems, coding systems.
- Ability to analyze and solve problems
- Strong communication and interpersonal skills.
- Knowledge of legal, regulatory, and policy compliance issues related to medical coding and documentation.
- Knowledge of current and developing issues and trends in medical coding diagnosis and procedure code assignment.
- Ability to clearly communicate medical information to physicians and CDIS staff.
- Ability to provide guidance and training to ACCDS coding and CDIS staff.