DRG Denials Analyst
Location Type: Remote Eligible
Job Number: 814411
Category: Professional & Executive
Job Number: 814411
Category: Professional & Executive
With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued employees. Ranked as the #1 hospital in Dallas-Fort Worth for the sixth consecutive year, we invite you to continue your healthcare career with us at William P. Clements Jr. University Hospital. You’ll discover a culture of teamwork, professionalism, and consistent opportunities for learning and advancement into leadership roles
UT Southwestern is honored to be a Veteran Friendly work environment that is home to approximately 800 veterans. We value your integrity, dedication, and the commitment you’ve made to our country. We’re proud to support your next mission.
To learn more about the benefits UT Southwestern offers visit https://www.utsouthwestern.edu/employees/hr-resources/.
Summary
The DRG Denials Analyst primary responsibilities are to review coding denials for inpatient hospital medical records, for accuracy of assigned codes, and ensure all Official Coding Guidelines and conventions were followed. Also, to ensure the clinical evidence and provider documentation supports the assigned codes and DRG.
Compose and submit appeal letters as appropriate, identify coding trends/opportunities for root causes of denials, which would be relevant for additional education to individual Coders/CDI Specialist’s and/or the entire Coding/CDI Teams. Report these trends/opportunities to the Clinical and Coding DRG Denials Supervisor to ensure education is developed and provided to the Coders and/or CDI Teams. Identify and communicate front-end activities that influence the denials/appeals process, seeking opportunities for process improvement.
Experience and Education
MINIMUM QUALIFICATIONS
Education/Experience
Job Duties
Knowledge, Skills & Abilities
I-10PCS, Official Coding Guidelines, and conventions, knowledge to interpret and apply Coding and CDI guidelines, etc.
Working Conditions
This job is Majority Remote.
This position will report to the Clinical and Coding DRG Denials Supervisor.
Any qualifications to be considered as equivalents in lieu of stated minimums require prior approval of the Vice President for Human Resources Administration, or his/her designee.
Security
This position is security-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information
UT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community. As an equal opportunity employer, UT Southwestern prohibits unlawful discrimination, including discrimination on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, gender expression, age, disability, genetic information, citizenship status, or veteran status.
Why are top candidates in so many professional fields – including customer service, finance, and human resources, to name a few – choosing UT Southwestern Medical Center as a career home? Simple. They know that they will work among a team of people who bring their best every day to support a health organization that’s breaking new ground in dozens of ways. That’s what we can offer you.
It takes a lot to keep UT Southwestern at the forefront, where world-class patient care, acclaimed medical education, and innovative research breakthroughs are common occurrences. When you join us, those are the challenges you’ll share. Our organization has taken on serious commitments and responsibilities within a rapidly evolving health care system.
Change is a constant, so our work supporting this complex matrix of business and systems needs must rise to the highest level of professionalism, collaboration, and innovation. That’s true for every role across the Medical Center and represents why this can be the most challenging work of your career.