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DIAGNOSIS RELATED GROUP SPECIALIST

TARRYTOWN, NY, US



“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

 

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

 

Education Requirements:

 

High School Diploma or GED

Certification by recognized national organization including:  RHIA  RHIT  CCS    CPC 

 

 

 

Department: Health Information Management Bargaining Unit: Non Union Campus: TARRYTOWN  Employment Status: Regular Full-Time Address: 555 South Broadway, Tarrytown
Shift: Day Scheduled Hours: 8:30 AM-5 PM Req ID: 148567 

 

Montefiore 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. 

 

N/A; #LI-AA1 


Mission:
To heal, to teach, to discover and to advance the health of the communities we serve.

Vision:
To be a premier academic medical center that transforms health and enriches lives.

Values
Define our philosophy of care, they shape our actions and motivate and inspire us to pursue excellence and achieve the goals we have set forth for the future. Our values include:

  • Humanity
  • Innovation
  • Teamwork
  • Diversity
  • Equity

 

 

 


Nearest Major Market: White Plains
Nearest Secondary Market: New York City