Coordinator, DRG Validation

The Coordinator, DRG Validation conducts coding audits to optimize diagnosis related groupings.  Develops and implements coding instruction classes.  Prepares coding guidelines.  Implements coding changes.

• Performs coding audits for DRG optimization.
• Demonstrates effective skills in DRG validation.
• Provides educational in-service to the coding and medical staff relating to DRG’s.
• Ability to communicate effectively with coders and medical staff.
• Acts as liaison to consultants.
• Prepares coding guidelines.
• Demonstrates knowledge of coding policy and procedures.
• Maintains knowledge of all current Federal and State coding guidelines
• Remains up-to-date on DRG system literature from all agencies.
• Knowledge, understanding of Federal and NYS DRG’s.
• Maintains coding clinic up-dates.
• Monitors and evaluates case mix index.
• Demonstrates comprehensive knowledge of case mix indexing.
• Reviews potential DRG reassignments.
• Demonstrates accurate and timely review of all DRG reassignments.
• Implements coding changes.
• Demonstrates ability to accurately and efficiently relate coding changes to staff.

• Bachelor’s Degree in Health Care Administration, Nursing, or a related field, required.
• RHIA, RHIT or RN, CCS, preferred.
• Minimum of two (2) years progressively responsible experience including familiarity with ICD-9-CM coding, DRG optimization methodology and case mix reimbursement, required.