Diskriter, headquartered in Pittsburgh,
Pennsylvania was established in 1947. Diskriter is a Health Information
Management solutions provider, serving clients across the United States since
1947. For the past 71 years, Diskriter has continually provided innovative and
technology driven Health Information Management solutions to the healthcare
industry. We have helped a broad range of HIM clients determine best practices
within each of several areas of emphasis: pure dictation, pure transcription,
integrated dictation and transcription systems and services, personnel
management, compensation and cost analysis, quality of documentation, workflow
analysis and design, coding (acute care, psych, rehab, and LTAC), compliance
auditing, RAC readiness, coder and clinician education and training, assembly
and analysis, and best-practice benchmarking.
Perform all related internal and external
coding audit activities. Codes and abstracts client's medical records to
determine data quality and accuracy of coding, billing and documentation related
to DRG's, APR DRG’s, APC's, CPT and HCPCS Level II code and modifier
assignments, ICD-10 diagnosis and procedure coding, DRG/APC structure according
to regulatory requirements. This position involves ICD-10 Auditing and Training
of all current and future Coders, ICD-10 Client, Physician Training, Coding
Policies and Procedures, Auditing feedback and Education to the team,
developing best practices (manuals, modules, etc.), and general day-to-day
operations of the Contracted Services and Consulting Services. Travel to Client
sites, Diskriter’s Headquarters will be required on an as-needed basis. Report
findings and communicate results to the team as well as Management. Use information
to generate topics for client education, training, process changes, risk
reduction, optimization of reimbursement. Audit coders' performance on a
regular and continuous basis. Prepare and distributes audit results/reports for
the system coding compliance program. Identify trends and educational
opportunities and assists with training. Prepare and present educational programs
related to coding. Assist with other audits as requested. Serve as a knowledge
expert and maintains up-to-date working knowledge of coding guidelines in order
to act as resource and point person for issues and question for coders,
customers and project teams. Coordinate and direct the day-to-day coding
educational activities. Facilitate and provide coding educational
classes/documents/presentations to staff on an ongoing basis. Responsibilities
also include doing root cause analysis of coding quality issues, performing
account reviews, and preparing training documents to assist with coding quality
action plans. This position also requires performing job responsibilities in a
timely fashion; to personally represent the Company and uphold its standards;
to adhere to all Diskriter Policies and Procedures; and to assist in setting
the standards of excellence for service and support in HIM division.
Ø Review inpatient as well as outpatient
charts for accurate and timely coding that is supported by medical record
documentation and is in accordance with clients' Facility and Official Coding
Ø Provide guidance on documentation
requirements, queries, and documentation improvement processes.
Ø Communicate audit findings to coding
staff, including applicable references, as appropriate.
Ø Perform auditing functions including
monitoring, coding of diagnosis, reviewing medical record documentation and
discharge summaries to determine if appropriate code was assigned to ensure
compliance with clients specification and coding standards.
Ø Provide coding related support to
Ø Compile and report statistical data to
management and customers.
Ø Review, develop and deliver training
programs and educational materials to address deficiencies identified in the
internal coding audits as well as client audits.
Ø Participate with management in the
assessment of audit findings and interact with coders to resolve issues.
Ø Provide guidance to clients in response
to external coding audits conducted and help them in determining appeal action,
preparing appeal letter follow up and identifying education issues.
Ø Develop audit detail summary reports and
address any coding, documentation, financial impact and profitability as a
result of audits.
Ø Conduct education/training presentations
of final audit findings to internal coders, client’s staff, physicians and
Ø Validate the ICD-10 CM, ICD-10 PCS, CPT
and HCPCS Level II codes and modifier systems, missed secondary diagnoses and
procedures and ensures compliance with DRG/APC structure and regulatory
Ø Provide or arrange for education/training
of coders and other healthcare professionals in use of coding guidelines and
practices, proper documentation techniques, medical terminology and disease
processes as it relates to the DRG/APC and other clinical factors.
Ø Based on coders profile and their
performance design and implement coder specific training program.
Ø Code, Audit charts and provide feedback,
Education and Training to coding staff as on a routine basis.
Ø Respond to coding-related questions from
Ø Perform account reviews for denials and
Ø Create response, report for denials and
help client appeal wherever required.
Ø Design education plans and education
Ø Review and interpret client’s medical
information, classify that information into the appropriate payer specific
groups consisting of ICD-10 CM ICD-10 PCS and CPT codes for diagnoses and
procedures and calculate the DRG and APC.
Ø Perform other duties as assigned or
required including performing audits and research related to special projects.
ESSENTIAL JOB FUNCTIONS:
Ø Strive to meet and exceed Company
production/quality and turnaround time minimums.
Ø Create an atmosphere of accepting all
others; treats co-workers with dignity and respect; builds positive, productive
work relationships for self as well as others in the team.
Ø Maintain excellent attendance and
punctuality. Adhere to pre-approved work schedule. Do not abuse the privilege
Ø Adjust schedule accordingly as client and
Coder needs change.
Ø Assist in any functions that are in need
Ø Required to perform Coding and Auditing
work based on operational needs.
Ø Maintain and work to attain client
Ø Enforce all Coding policies and
Ø Research and utilize programs as needed
for training and education of staff and clients.
Ø Attend, facilitate and participate in
Ø Create and update training manuals for
Coders and other Auditors.
Ø Ensure projects are completed on time and
Ø Provide subject matter expertise.
EDUCATION AND EXPERIENCE:
Ø CPC or CCS or RHIA,
RHIT certification required.
Ø Certifications (ICD-10 Trainer, etc) are a plus and encouraged.
Ø Experience in reimbursement, Denials and Appeals processing are a plus
Ø Passionate trainer with training expertise is must and skills includes
identifying coding training opportunities; developing training plans and
material, and instruction/delivery of the training to medical coder and
Ø Minimum of 5 years of Coding, Auditing experience in hospital coding
and/or auditing, as well as, education techniques and methods is required.
In-depth knowledge of ICD10- CM, ICD-10 PCS and CPT, HCPCS coding systems is
Ø Minimum of one to two
years of coding auditing experience with a strong background in inpatient and
outpatient coding and reimbursement is required.
Ø Experience in HIM with a focus on revenue cycle, coding, medical records
management, work flow, and process is required.
Ø Extensive ICD 10 knowledge as well as reimbursement methodologies.
Ø Strong knowledge of
both inpatient as well as outpatient coding is required. Must be proficient in
DRG/APC structure, National Correct Coding Initiatives, ICD-10 CM/PCS Official
Guidelines, Outpatient Prospective Payment System and Coding Clinic References.
Ø Current working
knowledge of encoder, grouper, abstracting and other related software.
Ø Attention to detail,
Strong analytical and communication skills are required.
Ø Past auditing and
strong education/training background in coding and reimbursement preferred.
Ø Experience and knowledge of healthcare informatics is desirable.
Experience in an acute care health information management setting is required
including policy development and implementation.
Ø Work successfully with clients in all healthcare settings.
Ø Must be Goal oriented.
Ø Work independently and under pressure with time constraints and
Ø Excellent written and oral communication skills, both listening and speaking;
presentation skills are required.
Location: Remote, AA (Work