DRG/APC Coordinator in Mobile, Alabama

Company: University of South Alabama

DRG/APC Coordinator


Not Displayed

Not Displayed


Medical Records MC, AL

Medical Records MC, AL

Job Type

Regular Full-time


USA Medical Center

Job Number




+ Description

+ Benefits

About Us

The University of South Alabama Health System helps people lead longer, better lives through its excellence in education, research and medical care. With more than 3,600 employees, USA's health network includes USA Medical Center, USA Children's & Women's Hospital, USA Mitchell Cancer Institute, USA Physicians Group and the USA College of Medicine. Each year, our team of 180 physicians, 240 residents and fellows, 70 mid-level providers and 800 nurses handle some 185,000 clinic visits and 350,000 outpatient procedures. The USA Health System delivers 2,800 babies a year, more than any other regional hospital, and treats patients through some 60,000 emergency room visits annually.

In addition to advanced and innovative patient care offered at University hospitals and clinics, USA's medical education programs provide first-class training experiences for the next generation of physicians and scientists. The USA Health System delivers excellence in care while improving the quality of life for residents across the Gulf Coast.

The USA Health System is managed by the USA HealthCare Management, LLC.

Essential Functions

Analyzes Medicare/Champus inpatient and outpatient surgery records and assigns the correct ICD-9 diagnosis and CPT procedure codes; ensures the diagnoses and procedures have been accurately documented in the medical record by the physician; utilizes the encoding system to assist in obtaining correct codes; properly identifies the principal diagnosis, secondary diagnoses, and procedure codes as required by CMS; reviews all Alabama Quality Assurance Foundation denials and changes and determines the proper course of action and completes the necessary action for resolution; communicates with hospital business office to answer questions concerning coding and billing issues; refers problems to Manager of Medical Records for further action; reviews records where Medicare/Champus are secondary payors; reviews records where the financial class is changed to Medicare/Champus; refers all encoder/grouper problems to hospital information systems promptly for resolution; stays informed of CMS coding changes through the review of the federal register, CMS websites, and other publications such as the Coding Clinic and CPT Assistant; assists business office with combining accounts; accurately codes a minimum of two Medicare/Champus inpatient records per hour and a minimum of five outpatient surgery records per hour; reviews records and coordinates data for Alabama Quality Assurance Foundation Studies; works with medical staff, social services, and case managers concerning documentation requirements and the assignment of working DRGs; maintains accurate and complete records; identifies and posts all forms and reports in the correct chart order; maintains accurate logbooks; updates CARLOS information as needed; removes specified forms/reports from the medical record for reviewers/requestors; accesses and accurately maintains electronic and paper medical records; verifies that information sent via fax machine was done so without error by reviewing the fax log; abides by and enforces all compliance requirements and policies; adheres to hospital policies including confidentiality; adheres to current Infection Control/Safety Standards; assists with orientation of new employees as assigned; communicates and uses appropriate customer relation skills with physicians, patients, families and healthcare team in person and via telephone; responds to overhead pages; informs/relays information to incoming shifts regarding unfinished requests/duties; utilizes and accesses the Hospital Information System, encoder, internet, and CARLOS via personal computer; regular and prompt attendance and the ability to work schedule as assigned and overtime and call as required; related duties as required.

Minimum Requirements

Associate's degree in Health Information Technology from an accredited institution as approved and accepted by the University of South Alabama or successful completion of a program in practical nursing and current licensure with the State of Alabama as a Licensed Practical Nurse, five years of experience coding inpatient/outpatient Medicare/Champus records in an acute care hospital setting, registration with AHIMA as a Registered Health Information Technician, and certification as a Certified Coding Specialist from the AHIMA or certification as a Certified Professional Coder - Hospital from the American Academy of Professional Coders.A bachelor's degree in Health Information Management or a bachelor's degree in nursing and current licensure with the State of Alabama as a registered nurse is highly preferred and will substitute for two years of the required experience.Registration with the AHIMA as a Registered Health Information Administrator is highly preferred.

Working Days and Hours

Monday - Friday / Rotating

00 a.m.

- 4:
30 p.m.

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