DRG Specialist – HIM
Montefiore Medical Center
The DRG Specialist provides expert level coding consultation and guidance for complex medical records that need research and reference checking; serves as a project leader for projects related to quality of ICD-10 coding and evaluation of revenue impact; researches and advises HIM management regarding feasibility of coding products, educational tools, analyzes data to identify areas for improvement, oversees coding function in the absence of manager; assists in the orientation and education of the coding staff. Provides responses to denials of payment, evaluates recommendations of Coding Validation consultants. Performs all duties of the Senior Medical Audit Analyst. Performs related work as required.
This position is in Tarrytown, NY.
- Bachelor’s degree in a health-related field or significant work experience appropriate to carry out the responsibilities of this position preferred.
- Expert clinical knowledge to analyze a medical record. Prior clinical experience with a documentation improvement program is a plus.
- Knowledge of the elements of disease processes and related procedures.
- Ability to build effective partnering relationships with providers and other clinical staff, Finance and payer representatives to problem solve and improve quality
- Knowledge of various DRG groupings and reimbursement methodologies
- Excellent critical thinking, verbal and written communication skills. Experience in writing denial appeals a plus
- Basic computer skills and knowledge of word processing, spreadsheet and database programs.
- Strong organizational and time management skills
- Ability to multitask and meet targets
- 3-5 years previous DRG/coding validation experience
- High School Diploma or GED required
- Certification by recognized national organization including: RHIA RHIT CCS CPC
Montefiore (https://www.montefiore.org) is an equal employment opportunity employer. Montefiore will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law.
Instructions for Resume Submission:
To be considered:
Qualified candidates should e-mail a résumé, cover letter summarizing their interest and background to Ann Marie Atako, AATAKO@montefiore.org.