DRG Coding Auditor

Overview

As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA

This position audits the accuracy and completeness of diagnosis and procedure coding, DRG assignment, and abstracted data to support that appropriate reimbursement and clinical severity is captured for the level of service rendered. Provides ongoing education to coders, physicians, and other clinical staff. The incumbent serves in an advisory and educator role for coding and regulatory compliance.

Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes.

Responsibilities

Essential Functions

• Reviews inpatient medical records post-discharge and pre-bill, audits the accuracy and completeness of diagnoses, procedure coding, abstracted data and DRG assignment.
• Reviews non-CC/MCC records to determine if the record was coded correctly or if additional codes may be reported by obtaining documentation supported by clinical indicators and treatment.
• Develops and coordinates coding education and formal training programs.
• Improves documentation by participating in the CDI query audit process.
• Works effectively with the Coding Manager to improve Inpatient coding accuracy.

Knowledge / Skills / Abilities

• Possesses knowledge of DRG and grouping methodologies, in particular what diagnoses and procedures impact DRG assignment.
• Possess strong knowledge of the diagnosis and procedure codes.
• Excellent interpersonal skills to develop relationships necessary to facilitate and educate.
• Excellent prioritization and organizational skills.

Qualifications

Required

• Bachelor''s degree or a minimum of six years experience of HIM Management.
• Four years of experience with coding ICD-10.
• Clinical Coding Specialist (CCS) certification.

Licenses Required

• One of the following

• Current Certified Documentation Improvement Practitioner (CDIP) through the AHIMA or obtain within 6 months of hire

• Current CCDS Certification with The Association of Clinical Documentation Improvement Specialists (ACDIS).

• Additional license requirements as determined by the hiring department.

Qualifications (Preferred)

Preferred

• RHIA/RHIT

Working Conditions and Physical Demands

Employee must be able to meet the following requirements with or without an accommodation.

• This is a sedentary position that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions.

Physical Requirements

Color Determination, Listening, Manual Dexterity, Near Vision, Sitting, Speaking, Standing