DRG Integrity Specialist
Company: Accuity
Location: Jacksonville
Posted on: September 23, 2024
Job Description:
Job Type
Full-time
Description
Accuity 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 six years, we have experienced rapid
growth and are excited to continue in growing our team nationwide.
Learn more about us at .
As a valued member of the DRG Review Team, the DRG Integrity
Specialist performs a secondary level review of medical records and
code assignment using knowledge of Accuity technology and client
systems with a physician in accordance with federal coding
regulations and guidelines as well as client specific coding
guidelines to ensure accurate DRG assignment. This function
requires a broad knowledge of the compliance structure to support
the appropriate reimbursement.
Primary Responsibilities
- Review pre-bill cases simultaneously with a physician during
each work shift excluding breaks and meetings to analyze and
validate diagnosis and procedure codes for inpatient services via
coding compliance and clinical knowledge to support accurate DRG
assignment
- Utilizes Accuity technology for tracking of coding errors,
query opportunities and other data collection as needed
- Researches, analyzes, and responds to inquiries regarding
compliance, inappropriate coding, and client denials
- Possesses a high level of dependability and ability to meet
Accuity coding recommendations, accuracy rate, and production
standards
- Interacts with Accuity physicians, peers, CDIS, and management
regarding documentation, policies, procedures, and regulations
- Interacts with management on an ongoing basis including
assisting senior level staff in providing recommendations for
process improvement so that productivity and quality goals can be
met or exceeded, and operational efficiency and financial accuracy
can be achieved
- Reviews, develops, modifies, and/or adapts relevant client
procedures, protocols, and systems to coordinate with Accuity
methodology
- Creates and provides group education and training based on
accurate coding practices, coding compliance documentation, and
regulatory provisions
- Attends in-house training sessions to receive updated coding
information and changes in coding and/or regulations
- Adheres to stringent timelines consistent with project
deadlines and directives
- Ensures strict confidentiality of patient medical records
- Always acts in an ethical and collaborative manner while
monitoring own work to help ensure quality
- Codes medical records as needed based on organizational
needs
- Performs miscellaneous job-related duties as assigned
Requirements
Education:
- High School Diploma or GED required
- Associates Degree in Health Information Management or similar
preferred
Experience:
- Minimum 4 years of inpatient coding experience in hospital
facility coding
- Minimum 2 years of experience that is directly related to the
duties and responsibilities specified above
- Experience and knowledge in DRG reimbursement (i.e., MS-DRG,
APR-DRG)Licensure and/or Credentials:
- Coding credential required from AHIMA/AAPC (RHIA, RHIT, CCS
and/or CPC)Knowledge, Skills, and Abilities:
- Knowledge of auditing concepts and principles
- Expert 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
- Critical thinking skills 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 when needed
- Ability to use a PC in a Windows environment, including MS
Word
- Independent, focused individual able to work remotely or
on-site
Keywords: Accuity, Jacksonville , DRG Integrity Specialist, Other , Jacksonville, Florida
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