Company: Acuity Search Solutions, Inc.
Posted on: January 27, 2023
(Only QUALIFIED Healthcare Professionals accepted) Immediate
need for a DRG Validation Specialist!!!
FULLY REMOTE - Hospital located in the NYC area.
I have a Coding Quality Validation Specialist Position with one of
the top Hospitals in the Country! This is a large acute care
hospital that has won more awards in the New York City area than
any other Hospital. It is ranked in the top 25 Hospitals in the
country! I'd love to help you further your career by joining a team
Call David at 513-206-9881
and/or send resumes to: email@example.com
Job Summary and Responsibilities: The Coding Quality Validator is
responsible for monitoring compliance with applicable clinical
documentation to support coding and billing regulations to insure
1. Reviews DRG assignment for selected Medicare/Medicaid
inpatients, HAC, PSI and Healthgrade target diagnoses for the
purpose of reimbursement, research and statistics in compliance
with federal regulations according to ICD-9, ICD-10 and CPT-4
coding classification systems.
2. Analyzes physician documentation in the medical record for
clinical correlation for coding accuracy and queries physicians
when code assignments are not straightforward or documentation in
the medical record is inadequate, ambiguous, or unclear for coding
3. Provides guidance on any changes made during their review to the
Inpatient Coders by furnishing input as necessary in addition to
education regarding applicable coding clinics or coding
4. Analyzes clinical data of CDMP Severity Complexity worksheets
and applies tracking codes.
5. Provides guidance to the Clinical Documentation Specialists by
furnishing input as necessary in addition to education regarding
applicable coding clinics or coding guidelines.
6. Performs data analysis and statistical gathering on a monthly
basis with regards to DRG, CPT, Public Reporting, HAC compliance
which is then presented to the Chief Compliance Officer
7. Makes recommendations on documentation improvement needs within
the facility to improve patient care.
8. Applies POA indicators on all inpatient charts.
9. Brings identified concerns to supervisor or department manager
10. Enters data such as diagnosis and procedure codes and charts
abstracted information for APC and DRG assignments into the 3M
coding computer system.
11. Assists the Inpatient HIM Supervisor and Inpatient Coding
Manager with education sessions for coding staff.
12. Assists in chart completion to ensure DNFB goals are met.
13. Assists in special projects when applicable such as in-house
audits or audits pertaining to contract coders.
14. Creates spreadsheets and summary of findings.
15. Attends monthly coding in-services provided by the Inpatient
16. Assists the coding staff when needed.
17. Keeps abreast of coding guidelines and reimbursement reporting
requirements, new technology and procedures as well as CMS approved
18. Abides by the Standards of Ethical Coding as set forth by the
American Health Information Management Association and adheres to
official coding guidelines.
19. Adheres to standards identified in the Medical Center's
Working Conditions: Lifts a minimum of 5lbs., pushes and pulls a
minimum of 5lbs., and stands a minimum of 1/2 hour.
Education, Knowledge, Skills and Abilities Required:
1. Associate's degree or higher.
2. Minimum of 5 years of inpatient coding experience in a complex
3. Minimum 2 years of quality improvement audit.
4. Experience and thorough knowledge of ICD-9, ICD-10, CPT and DRG
5. Knowledge of data reporting requirements and proficiency in
6. Extensive knowledge in data collection and clinical reviews.
7. Excellent written, verbal, and interpersonal co
Keywords: Acuity Search Solutions, Inc., Hackensack , DRG Validator, Other , Hackensack, New Jersey
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