Assistant Manager - Brand Marketing-Auditors-DRG CVA

As a Certified Coding Specialist (CCS) and Certified Inpatient Coder (CIC), your role will involve the following key responsibilities: Role Overview: You will be responsible for conducting detailed DRG validation audits on selected inpatient medical records to ensure coding accuracy, completeness, and compliance with ICD-10-CM/PCS, AHA Coding Clinic, and CMS guidelines. Your role will involve reviewing documentation to confirm that all reported diagnoses and procedures are supported and coded to the highest level of specificity. You will also validate the assignment of the discharge disposition, Present on Admission (POA) indicators, and sequencing of diagnoses. Identifying and correcting discrepancies between coded data and clinical documentation will be crucial, along with performing secondary reviews for complex or disputed coding cases. Key Responsibilities: - Conduct detailed DRG validation audits on selected inpatient medical records - Review documentation to confirm coding accuracy and completeness - Validate assignment of discharge disposition, POA indicators, and sequencing of diagnoses - Identify and correct discrepancies between coded data and clinical documentation - Perform secondary reviews for complex or disputed coding cases Qualifications Required: - Mandatory Certification: CCS - Certified Coding Specialist, CIC - Certified Inpatient Coder In addition to the above responsibilities, you will collaborate with the Compliance Department to address audit findings and ensure regulatory adherence. You will also provide ongoing feedback and coaching to coders and Clinical Documentation Improvement (CDI) Specialists to enhance coding accuracy and documentation quality. Developing and delivering targeted training sessions on DRG optimization, clinical indicators, coding guidelines, and audit findings will be part of your responsibility. Moreover, you will maintain detailed and accurate records of all audit activities and findings, prepare periodic audit reports summarizing trends, root causes, and recommendations for improvement, and communicate results to management while participating in performance improvement initiatives. Lastly, you will work closely with CDI teams, physicians, and other clinical staff to clarify documentation and ensure accurate code assignment, as well as partner with IT and data analytics teams to improve coding and auditing processes.,