Responsible for serving as a key resource to the Care Management and hospitalist clinician team for concurrent DRG coding. Provides support to claims and management team. Works closely with management on special projects.
Consistently exhibits behavior and communication skills that demonstrate HealthCare Partners’ (HCP) commitment to superior customer service, including quality, care and concern with each and every internal and external customer.
Provides feedback to physician director, Care Management, HCP hospitalist for concurrent admissions on the likely DRG code, DRG outlier status, and DRG reimbursement.
Serves as a key contact and liaison with clinicians to answer coding questions.
Provides individualized sessions with clinicians for specific coding issues based on medical chart audit results.
Maintains database of admissions in which concurrent DRG feedback was provided.
Upon discharge and claim submission, performs validation and analysis of concurrent DRG feedback.
Provides updates and status reports to management on a weekly basis.
Stays abreast of industry coding and compliance issues.
Participates in coding / auditing discussions to ensure best practice efforts and processes are implemented ensuring maximum reimbursement through appropriate coding.
Uses, protects, and discloses HCP patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
Performs additional duties as assigned.
Knowledge, Skills, and Abilities
- Computer literate.
- Working knowledge of 10-key calculator.
- Working knowledge of general office duties.
- Working knowledge of contracted insurance plans.
- Good verbal and written communication skills. Ability to use correct English grammar and spelling.
- Hospital coding certificate from AHIMA or AAPC.
- Hospital coding experience.
- Good telephone skills.
- Customer-service oriented.
- Ability to maintain courteous and friendly demeanor when dealing with the public and co-workers.
- Ability to work in a fast-paced team-oriented environment.
- Bilingual preferred.
DaVita Medical Group manages and operates medical groups and affiliated physician networks in California, Colorado, Florida, Nevada, New Mexico, Pennsylvania and Washington. A leading independent medical group in America, DaVita Medical Group has over two decades of experience providing coordinated, outcomes-based medical care in a cost-effective manner. As of June 30, 2017, DaVita Medical Group’s teammates, employed clinicians and affiliated clinicians provided care for approximately 1.7 million patients. DaVita Medical Group’s leadership development initiatives and social responsibility efforts have been recognized by Fortune, Modern Healthcare, Newsweek and WorldBlu.