DRG Integrity Specialist

3 weeks ago

Seattle WA United States Accuity Full time


Job Type


Full-time



Description


POSITION SUMMARY:

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 JOB 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


POSITION QUALIFICATIONS:

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, or CIC)

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
#J-18808-Ljbffr

  • Coding Specialist II

    4 weeks ago

    Columbia, MD, United States MEDSTAR HEALTH Full time

    General Summary of PositionMedStar Health is seeking an experienced Inpatient Coding Specialist who is self-motivated, has a CCS certification and 3 years of inpatient acute care coding experience with knowledge in MS-DRG to join our team!MedStar Health provides the latest technology including our EMR Cerner MedConnect, 3MHDM and 3m360 computer-assisted...

  • Healthcare IT Integration Specialist

    3 weeks ago

    Seattle, WA, United States Mastech Inc. Full time

    Mastech Digital is an IT Staffing and Digital Transformation Services company. Mastech Digital provides digital and mainstream technology staff as well as Digital Transformation Services for all American Corporations. We are currently seeking a Healthcare IT Integration Specialist for our client in the Health Care/Consulting domain. We value our...

  • Integration Specialist

    2 weeks ago

    Seattle, United States Robert Half Full time

    Job DescriptionJob DescriptionWe are seeking an Integration Specialist to join our team in a remote capacity. This role offers a contract to permanent employment opportunity. As an Integration Specialist, you will primarily be responsible for automating business processes, managing API integrations and handling various projects that involve syncing data...

  • TalentBurst | Workday Integration Specialist WA | seattle, wa

    4 weeks ago

    Seattle, WA, United States TalentBurst Full time

    Title:Workday Integration Specialist Location: Seattle, WA 98101- Hybrid 2-3 Days Onsite. Duration: 3 Months 35537935 Job Summary: The Workday Integration Specialist will be responsible for configuring, maintaining, and optimizing Workday systems within our large enterprise environment. This role requires advanced Workday Studio, VIP , and Core...

  • Integration Specialist

    2 weeks ago

    Seattle, Washington, United States Futran Tech Solutions Pvt. Ltd. Full time

    Job RequirementsFutran Tech Solutions Pvt. Ltd. is looking for an experienced Integration Specialist to join our team in Seattle, WA.The estimated annual salary for this role is $110,000 - $150,000.About the Role:Develop and implement integrations between systems using Boomi.Work closely with stakeholders to understand requirements and deliver effective...

  • Medical Director

    3 weeks ago

    Detroit, MI, United States Accuity Full time

    The Medical Director, working together with a coder (DRG Integrity Specialist), will review inpatient charts to ensure the acuity and complexity of the patient's hospital stay is appropriately captured in the clinical documentation and translated into coding. The Medical Director is responsible for capturing the true clinical picture in a manner compliant...

  • Integration Specialist

    2 weeks ago

    Seattle, United States Tailored Management Full time

    If you are interested reply with your updated resume and let me know when we can connect to discuss about the role.This is an excellent opportunity to join our client, an American leading fashion retailer that offers compelling clothing, shoes and accessories for men, women and kids. Since 1901, they've been committed to providing their customers with the...

  • Enterprise Integration Specialist

    4 weeks ago

    Seattle, Washington, United States Futran Tech Solutions Pvt. Ltd. Full time

    Job Description:We are seeking an experienced Enterprise Integration Specialist to join our team at Futran Tech Solutions Pvt. Ltd. in Seattle, a hybrid location that offers the best of both worlds.About the Role:This is a challenging and rewarding role that requires strong technical expertise in designing, building, and deploying messaging solutions using...

  • Medical Director

    4 weeks ago

    Salt Lake City, UT, United States Accuity Full time

    Job Type Full-time Description The Medical Director, working together with a coder (DRG Integrity Specialist), will review inpatient charts to ensure the acuity and complexity of the patient's hospital stay is appropriately captured in the clinical documentation and translated into coding. The Medical Director is responsible for capturing the true...

  • Medical Director

    3 weeks ago

    Little Rock, AR, United States Accuity Full time

    Job Type Full-time Description The Medical Director, working together with a coder (DRG Integrity Specialist), will review inpatient charts to ensure the acuity and complexity of the patient's hospital stay is appropriately captured in the clinical documentation and translated into coding. The Medical Director is responsible for capturing the true clinical...

  • Workday Integration Specialist

    2 weeks ago

    Seattle, United States Tailored Management Full time

    Job Title: Workday Integration Specialist Location: Seattle, WA - Hybrid Duration: 3-4 Months (Possibility of Extension) Pay rate: $78 - $82/hr on w2 Work Timings:10am-8pm Job Summary: The Workday Integration Specialist will be responsible for configuring, maintaining, and optimizing Workday systems within our large enterprise environment. This...

  • workday integration specialist

    2 weeks ago

    Seattle, United States Randstad Full time

    workday integration specialist. seattle , washington posted december 6, 2024 job details summary $78.87 - $82.39 per hour contract bachelor degree category computer and mathematical occupations reference1074263 job details job summary: The Workday Integration Specialist will configure, optimize, and maintain Workday systems in a large enterprise...

  • Workday Integration Specialist

    2 weeks ago

    Seattle, United States TalentBurst Full time

    Title:Workday Integration Specialist Location: Seattle, WA 98101- Hybrid 2-3 Days Onsite. Duration: 3 Months 35537935 Job Summary: The Workday Integration Specialist will be responsible for configuring, maintaining, and optimizing Workday systems within our large enterprise environment. This role requires advanced Workday Studio, VIP , and Core...

  • Workday Integration Specialist

    2 weeks ago

    Seattle, United States SPECTRAFORCE Full time

    Title: Workday Integration Specialist **************Only W2Location: Seattle, WA (Hybrid)Duration: 3 monthsJob Summary: The Workday Integration Specialist will be responsible for configuring, maintaining, and optimizing Workday systems within our large enterprise environment. This role requires advanced Workday Studio, VIP, and Core Connectors skills and at...

  • Workday Integration Specialist

    1 week ago

    Seattle, Washington, United States Tailored Management Full time

    Job Title: Workday Integration SpecialistLocation: Seattle, WA - HybridDuration: 3-4 Months (Possibility of Extension)Estimated Salary: $78-$82 per hour on W2Work Timings: 10am-8pmAbout the Role:The Workday Integration Specialist will be responsible for configuring, maintaining, and optimizing Workday systems within our large enterprise environment.This role...

  • Coding Specialist II

    3 weeks ago

    Columbia, MD, United States MEDSTAR HEALTH Full time

    General Summary of Position MedStar Health is seeking experienced Inpatient Medical Coders that are self-motivated and have at least 3 years of inpatient acute care coding experience with knowledge in MS-DRG and/or APR-DRG. Qualified candidates must have their CCS (Certified Coding Specialist) through AHIMA. MedStar Health provides the latest technology...

  • Coding Appeals Specialist

    4 weeks ago

    Allentown, PA, United States St. Luke's University Health Network Full time

    St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other...

  • Senior Appian Integration Specialist

    1 week ago

    Seattle, Washington, United States Futran Tech Solutions Pvt. Ltd. Full time

    Futran Tech Solutions Pvt. Ltd. invites applications for the position of Senior Appian Integration Specialist. We are looking for a seasoned professional to lead our team of distributed engineers and deliver complex Appian integrations with external systems. Key responsibilities include designing, implementing, and maintaining high-quality integrations,...

  • Senior Systems Integration Specialist

    1 week ago

    Seattle, Washington, United States InterSources Full time

    Senior Systems Integration SpecialistWe are seeking a highly skilled Senior Systems Integration Specialist to join our team at InterSources Inc. As a key member of our integration team, you will be responsible for designing and implementing complex systems integrations that meet the needs of our clients.The ideal candidate will have extensive experience in...

  • Senior Data Integration Specialist

    1 week ago

    Seattle, Washington, United States Futran Tech Solutions Pvt. Ltd. Full time

    Job Title: Senior Data Integration SpecialistFutran Tech Solutions Pvt. Ltd. is seeking an experienced Senior Data Integration Specialist to join our team. This role involves contributing substantially to the design, development, testing, and deployment of an enterprise data warehouse (EDW) using Pentaho Data Integration.About the Role:Develop code to...