Dignosis Related Group Auditor

Our team members are the heart of what makes us better.

At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community.

Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change.

The Diagnosis Related Group (DRG) Auditor is responsible for auditing clinical documentation that supports code assignment for compliance with billing regulations, this includes compliance with the Conditions of Participation for CMS. The DRG auditor is responsible for ensuring coding accuracy, coding consistency and efficiency in filing of inpatient claims. Collaborates with the Clinical Documentation Quality Liaison to assist in reviewing quality initiatives directed at system-wide quality indicators (i.e. Mortality, Patient Safety Indicators [PSI], Hospital Acquired Conditions, Severe Maternal Morbidity, etc.) and clinical evidence to support Diagnosis-related group (DRG), principal diagnosis, and secondary diagnoses assignments. All duties are performed across the Hackensack Meridian Health (HMH) network.

Qualifications:

Education, Knowledge, Skills and Abilities Required:

• Bachelor's Degree or equivalent years of experience.
• Formal Health Information Management (HIM) education.
• Minimum of 5 years progressive coding review in ICD-10-CM and DRG methodologies.
• Knowledge of POA/HAC, PSI and core measures.
• Knowledge in data collection.
• Good oral and written communication skills.
• Excellent written and verbal communication skills.
• Proficient computer skills including but not limited to Microsoft Office and Google Suite platforms.

Education, Knowledge, Skills and Abilities Preferred:

• Knowledge of the DRG structure and regulatory requirements.
• Experience in claims processing and data management responsibilities.
• Knowledge in Patient Safety/Quality Management.
• Auditing experience.

Licenses and Certifications Required:

• Certified Coding Specialist.

Licenses and Certifications Preferred:

• Registered Health Information Administrator Certification or Registered Health Information Technician.

If you feel that the above description speaks directly to your strengths and capabilities, then please apply today!