Diagnosis Related Group (DRG) Coordinator reviews inpatient hospital records for accurate diagnosis, procedure, and billing codes. Monitors data quality in order to maximize reimbursement. Being a Diagnosis Related Group (DRG) Coordinator monitors the financial status of Medicare patient accounts in order to minimize potential loss. May require a bachelor's degree. Additionally, Diagnosis Related Group (DRG) Coordinator typically reports to a manager or head of a unit/department. The Diagnosis Related Group (DRG) Coordinator contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. To be a Diagnosis Related Group (DRG) Coordinator typically requires 4 to 7 years of related experience. (Copyright 2024 Salary.com)
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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.