DRG/APC Coordinator - Providence Hospital

USA Health is Transforming Medicine along the Gulf Coast to care for the unique needs of our community. 

USA Health is changing how medical care, education and research impact the health of people who live in Mobile and the surrounding area. Our team of doctors, advanced care providers, nurses, therapists and researchers provide the region's most advanced medicine at multiple facilities, campuses, clinics and classrooms. We offer patients convenient access to innovative treatments and advancements that improve the health and overall wellbeing of our community.

Analyzes Medicare/Medicaid inpatient and outpatient records and assigns the appropriate codes using ICD-10-CM/ICD-10-PCS/ICD-9-CM/CPT/3M coding systems; codes records within five days of discharge; codes a minimum of 2 Medicare Inpatient or 3 non-Medicare Inpatient or 6 Newborn Inpatient or 6 Obstetrical Inpatient or 5 Outpatient Surgery/Observation or 12 ER/OB Screening records per hour; records the principal diagnosis and procedure, as well as the sequence of all other diagnoses and procedures according to the uniform discharge data system; identifies complications and comorbidities in order to assign the most appropriate DRG/APR-DRG; develops and assigns physician coding queries when documentation clarification is needed in order to assign the most accurate and appropriate code; reviews all RAC denials related to coding: determines proper course of action, and completes the action necessary for resolution; assists physicians and Business Office by pulling charts, answering questions regarding billing and coding, and performing follow-up; reviews and actively works all coding queues and coding requests from the Business Office; informs Assistant Manager of Coding regarding any outstanding records not coded within five days of discharge; communicates with the medical staff and other healthcare providers on proper documentation of severity of illness and intensity of service to ensure optimal reimbursement; maintains accurate and complete records by completing the daily departmental routing slip, maintaining accurate logbooks, and updating Cerner and 3M information as needed; verifies that information sent via fax machine was done so without error by reviewing the fax log; informs/relays information to incoming shifts regarding any unfinished requests/duties; communicates and uses appropriate customer relation skills with physicians, patients, families and healthcare team in person and via telephone; responds to overhead pages; abides by and enforces all compliance requirements and policies; adheres to hospital policies including confidentiality; adheres to current Infection Control and Safety Standards; assists with orientation of new employees as assigned; utilizes and accesses the Hospital Information System (Cerner), 3M, Vincari and Command Health; informs Coding Supervisor when supplies are low; participates on committees as assigned; participates in Performance Improvement activities as assigned; regular and prompt attendance; ability to work schedule as defined and overtime and call as required; related duties as required.

Associate’s degree in Health Information Technology from an accredited institution as approved and accepted by the University of South Alabama or successful completion of a program in practical nursing and current licensure with the State of Alabama as a Licensed Practical Nurse, five years of experience coding inpatient/outpatient Medicare/Champus records in an acute care hospital setting, registration with AHIMA as a Registered Health Information Technician, and certification as a Certified Coding Specialist from the AHIMA or certification as a Certified Professional Coder – Hospital from the American Academy of Professional Coders. 

A bachelor’s degree in Health Information Management or Nursing and current licensure with the State of Alabama as a registered nurse is highly preferred and will substitute for two years of the required experience. Registration with the AHIMA as a Registered Health Information Administrator is highly preferred.

USA Health is an EO/AA employer and does not discriminate on the basis of race, color, national origin, sex, pregnancy, sexual orientation, gender identity, gender expression, religion, age, genetic information, disability, protected veteran status or any other applicable legally-protected basis.