Description

JOB DESCRIPTION:

Clinical Financial Resource, Inc. has an immediate need for full-time DRG Validators! Founded over 30 years ago, CFR provides certified coding specialists, registered nurses, and Board-Certified physicians with the experience and expertise necessary to establish optimal documentation, coding and billing for hospitals and large physician groups. We integrate this with the knowledge of clinical medicine to yield optimal revenue capture, improve publicly reported quality metrics, reduce DRG revision denials and improve CMS compliance.

This position requires a background in inpatient coding as you will be responsible for reviewing medical records to determine the accuracy of coding for diagnostic, procedural information, and the discharge status of the patient. DRG Validators will use both the physician’s notes and the patient’s medical records to ensure the codes are both correct and appropriately documented per the standards of the ICD-10 Coding Manual.

RESPONSIBILITIES:

As a DRG Validator, your job duties are, but are not limited to, the following:

• Validate the accuracy and appropriateness of the DRG assignments in regard to the selection of principal diagnosis, sequencing of additional diagnoses and procedure codes and to identify any additional diagnoses that were improperly coded or missed per coding guidelines.
• Query the physician to clarify documentation in the medical record for accurate code assignment.
• Proficiently use facility Encoders and EMRs including the auditing tools to make proper coding and audit determinations.
• Clearly and accurately rationalize your audit findings with references to support your findings.
• Consistently meet productivity and accuracy requirements.
• Respond in a timely manner to emails and communicate effectively with co-workers, physicians and management.
• Adhere to all HIPAA-related requirements to maintain patient confidentiality.
• Perform other related duties as assigned.

Requirements

• Minimum of 3 years of acute care hospital inpatient coding and DRG analysis experience
• Excellent knowledge of ICD-10 coding
• AHIMA certified, CCS preferred
• Extensive knowledge of clinical medicine, coding terminology and guidelines, and billing
• Excellent oral and written skills including proper spelling, grammar, punctuation, and sentence structure
• Skilled in Microsoft Excel, Outlook, EPIC and 3M and have the ability to learn to use new programs and applications easily
• Must be responsible, self-sufficient and self-motivated to meet production and accuracy rates in a remote setting