DRG/APC - Coding Auditor

Be a part of a world-class academic healthcare system at UChicago Medicine as a DRG/APC - Coding Auditor for the Health Information Management department. This is a remote, work from home opportunity and you may be based outside of the greater Chicagoland area.  

In this role, the DRG/APC Coordinator- Coding Auditor is responsible for ensuring accuracy and quality of coding assignments for all records requiring DRG and/or APC coding, and ensures optimal and timely reimbursement.  

Essential Job Functions 

• Performs data quality reviews on inpatient and outpatient records to ensure proper coding guidelines have been followed and appropriate DRG or APC assignments have been made for appropriate reimbursement 

• Provides DRG/APC and coding quality information and statistical reports to the Coding Manager 

• Communicates with the Medical Staff and House staff as needed to discuss clinical questions with respect to the assignment of ICD-10-CM and ICD-10-PCS codes for diagnoses and procedures 

• Educates the Medical Staff and House staff regarding the importance of sufficient documentation to support the assignment of the appropriate DRG/APC 

• Reviews Hospitals' specific coding guidelines and procedures and suggests changes and updates to the Coding Manager 

• Participates in team meetings with coding personnel to discuss coding problems, changes, or issues 

• Performs routine coding and abstracting as directed 

• Utilizes 3M encoder optimizing function to review data for accuracy 

• Reviews PRO coding changes, reports findings to the Coding Manager, and - provides appropriate documentation to the PRO when appealing a PRO decision 

• Maintains accreditation with AHIMA and abides by the Standards of Ethical Coding as set forth by the AHIMA 

• Remains current on all PRO, OIG and IPPS/OPPS rules and regulations, coding updates, changes and issues 

Required Qualifications  

• A bachelor's degree from an accredited academic body or in lieu of a completed degree; equivalent experience  

• Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA), and Certified Coding Specialist (CCS) credentials  

• Four (4) years coding experience with a minimum of two (2) years PPS coding, DRG grouping, & APC payment experience 

• Three (3) years of inpatient facility coding experience 

• Working knowledge of 3M HDM Abstracting System and 3M Codefinder/DRG finder; must have working knowledge of JCAHO standards for chart completion 

• Working knowledge of medico-legal rules and regulations that govern the confidentiality and release of medical information with the ability to interpret and implement the standards; must maintain total confidentiality of all patient records 

• Data entry skills  

Position Details: 

• Job Type/FTE: Full Time 

• Shift: Days   

• Location: Remote  

• Unit/Department: Health Information Management 
• CBA Code: Non-Union 

We’ve been at the forefront of medicine since 1899. We provide superior healthcare with compassion, always mindful that each patient is a person, an individual. To accomplish this, we need employees with passion, talent and commitment… with patients and with each other. We’re in this together: working to advance medical innovation, serve the health needs of the community, and move our collective knowledge forward. If you’d like to add enriching human life to your profile, UChicago Medicine is for you. Here at the forefront, we’re doing work that really matters. Join us. Bring your passion.

UChicago Medicine is growing; discover how you can be a part of this pursuit of excellence at: UChicago Medicine Career Opportunities.

UChicago Medicine is an equal opportunity employer.  We evaluate qualified applicants without regard to race, color, ethnicity, ancestry, sex, sexual orientation, gender identity, marital status, civil union status, parental status, religion, national origin, age, disability, veteran status and other legally protected characteristics.

Must comply with UChicago Medicine’s COVID-19 Vaccination requirement as a condition of employment. If you have already received the vaccination, you must provide proof as part of the pre-employment process. This is in addition to your compliance with the Flu Vaccination requirement as well. Medical and religious exemptions will be considered consistent with applicable law. Lastly, a pre-employment physical, drug screening, and background check are also required for all employees prior to hire.

Compensation & Benefits Overview

UChicago Medicine is committed to transparency in compensation and benefits.  The pay range provided reflects the anticipated wage or salary reasonably expected to be offered for the position.

The pay range is based on a full-time equivalent (1.0 FTE) and is reflective of current market data, reviewed on an annual basis. Compensation offered at the time of hire will vary based on candidate qualifications and experience and organizational considerations, such as internal equity. Pay ranges for employees subject to Collective Bargaining Agreements are negotiated by the medical center and their respective union.

Review the full complement of benefit options for eligible roles at Benefits - UChicago Medicine.