[Hiring] DRG/APC Coordinator @USA Health Systems

Role Description

The DRG / APC Coordinator is responsible for the following:

• Requires minimal supervision to safely perform all responsibilities.
• Maintains a clean and secure workstation.
• Utilizes and accesses the Hospital Information System (Cerner), 3M / Solventum, Vincari and any other applicable computer applications as assigned.
• Analyzes Medicare / DRG Payer inpatient records and assigns the correct ICD-10-CM diagnosis and ICD-10-PCS procedure codes for optimal reimbursement.
• Analyzes Medicare / APC / EAPG Payer outpatient and emergency room records and assigns the correct ICD-10-CM diagnosis, ICD-10-PCS procedure codes and the correct CPT or HCPCS procedure codes for optimal reimbursement.
• Assures the diagnoses and procedures coded have been documented in the medical record by the physician.
• Develops and assigns provider Coding Queries when documentation clarification is needed.
• Properly identifies the principal diagnosis, secondary diagnoses and any procedure codes as required by CMS.
• Reviews all coding denials and audits, determines proper course of action and effectively communicates and/or completes the action(s) necessary for resolution.
• Communicates with Hospital Business Office to answer questions concerning coding and billing issues and performs any follow-up as needed.
• Keeps the Coding Manager informed of problems and/or concerns.
• Refers all coding software problems to Coding manager promptly for resolution.
• Stays informed about coding changes and updates through the review of the Federal Register, CMS websites, publications such as the Coding Clinic and CPT Assistant, etc.
• Must be able to accurately code a minimum of 2 to 3 Medicare / DRG Payer inpatient records per hour and a minimum of 5 outpatient surgery / outpatient in a bed / outpatient / observation records per hour or 12 emergency room records per hour.
• Works with the medical staff, CDI, social services, nursing, ancillary care staff, discharge planning, utilization review and care managers concerning documentation requirements and the correct assignment of all coding.
• Actively reviews and works all coding queues as assigned by the Coding Manager to ensure the oldest accounts are coded first.
• Attends and/or assists the Coding Manager with coding meetings related to HACs, PSIs, PDIs, etc.
• Performs related duties as assigned.

The (DRG/APC Coordinator) documentation responsibilities include:

• Maintains accurate and complete records.
• Accurately assigns coding "holds" when documentation needed for coding is missing.
• Maintains accurate logbooks/spreadsheets.
• Updates Cerner/Solventum (3M) information as needed.

The (DRG/APC Coordinator) citizenship responsibilities include:

• Accepts and completes all duties positively and without conflict.
• Cooperates, helps others and improves the performance of the coding department.
• Completes all mandatory unit, educational and hospital requirements.
• Utilizes cost-effective practices in performing all aspects of the job.
• Adheres to current Infection Control and Safety Standards.

Other duties and responsibilities include:

• Other duties as assigned/required.
• Participates on committees and/or ad-hoc groups as assigned.
• Participates in Performance Improvement activities as assigned.

The (DRG/APC Coordinator) professional responsibilities include:

• Abides by and enforces all compliance requirements and policies.
• Adheres to hospital policies including confidentiality.
• Requires regular and prompt attendance.
• Works the assigned schedule including overtime as required.
• Assists with orientation of new employees and training of other coders as assigned.

The DRG / APC Coordinator's Communication Responsibilities include:

• Communicates and uses appropriate customer relation skills with physicians, patients, families and healthcare team in person and via telephone.
• Excellent written communication skills.
• Responds timely to emails and phone calls.
• Informs/relays information to Coding Manager regarding any unfinished requests and/or duties.
• Completes all mandatory department, educational and hospital requirements.
• Adheres to current Infection Control and Safety Standards.
• Regular and prompt attendance.
• Ability to work schedule as defined and overtime as required.
• Related duties as assigned.

Qualifications

• Associate's Degree in Health Information Technology or practical nursing and 5 years experience coding inpatient/outpatient Medicare/DRG Payer records in an acute care hospital setting Required OR
• Bachelor's Degree in Health Information Management or Nursing and current licensure with the state of Alabama as a registered nurse will substitute for 2 years of the required experience Preferred.
• RHIT - Registered Health Information Technician with AHIMA Upon Hire Required.
• CCS-Certified Coding Specialist from the AHIMA Upon Hire Required or
• Certification as a Certified Professional Coder - Hospital from the American Academy of Professional Coders Required.
• Current licensure with the state of Alabama as an LPN Required.
• Registry with the AHIMA as a Registered Health Information Administrator is highly Preferred.
• Comparable combination of education and experience may substitute for the above requirements.

Requirements

• Excellent computer, communication and customer service skills are required.
• Excellent verbal and written communications skills.
• Excellent organizational skills and attention to detail.
• Excellent time management skills with a proven ability to meet deadlines.
• Strong analytical and problem-solving skills.
• Must be organized and demonstrate the ability to follow policies and directives.
• Ability to multi-task in an efficient, thorough, and prioritized manner.
• Willingness to learn new skills and continuously improve knowledge, skills and abilities.
• Ability to act with integrity, professionalism, and confidentiality.
• Ability to maintain confidentiality of information, most importantly patient financial and health record information in accordance with federal and state laws and regulations.
• Ability to solve practical problems and deal with a variety of variables.
• Demonstrated ability to work independently and collaboratively on teams is required.
• Knowledge of ICD-10 and CPT coding systems.