USA Health is seeking a DRG/APC Coordinator to support Health Information Management operations for inpatient and outpatient coding across acute care settings. The role focuses on accurate assignment of ICD-10-CM, ICD-10-PCS, CPT, and HCPCS codes to ensure optimal reimbursement and compliance.
Key responsibilities include:
- Analyze Medicare/DRG payer inpatient records and assign accurate diagnosis and procedure codes.
- Review Medicare/APC/EAPG payer outpatient and emergency room records for correct coding assignment.
- Ensure diagnoses and procedures are supported by physician documentation.
- Create and assign coding queries when documentation clarification is needed.
- Identify principal and secondary diagnoses and applicable procedure codes according to CMS guidelines.
- Review coding denials and audits, determine corrective action, and communicate resolutions.
- Collaborate with the business office, CDI, nursing, social services, utilization review, and care management teams.
- Work coding queues in priority order to ensure accounts are coded within five days of discharge.
- Assist with coding meetings, committee participation, performance improvement activities, and training/orientation of new staff.
- Maintain accurate records, logbooks, spreadsheets, and system updates in Cerner, 3M/Solventum, Vincari, and related applications.
Requirements & Qualifications
Required qualifications:
- Associate's degree in Health Information Technology or practical nursing plus 5 years of inpatient/outpatient Medicare/DRG payer coding experience in an acute care hospital setting.
- RHIT certification through AHIMA upon hire.
- CCS certification through AHIMA upon hire, or Certified Professional Coder - Hospital (CPC-H) certification through AAPC.
- Current Alabama LPN licensure.
Preferred qualifications:
- Bachelor's degree in Health Information Management or Nursing.
- Current Alabama RN licensure may substitute for 2 years of required experience.
- RHIA credential through AHIMA is highly preferred.
Skills and abilities:
- Strong knowledge of ICD-10 and CPT coding systems.
- Excellent computer, written, and verbal communication skills.
- Strong organizational skills, attention to detail, and time management.
- Ability to multitask, work independently, and collaborate effectively with teams.
- Analytical and problem-solving skills with a focus on accuracy and compliance.
- Ability to maintain confidentiality and follow policies and directives.
Benefits & Perks
Employees working 20 hours or more per week (.50 FTE or greater) are eligible for benefits.
Location
Alabama, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
No
Posted
1 week ago