Senior DRG Validation Analyst

Join a team that delivers excellence.

Lehigh Valley Health Network (LVHN) is home to nearly 23,000 colleagues who make up our talented, vibrant and diverse workforce.

Join our team and experience firsthand what it's like to be part of a health care organization that's nationally recognized, forward-thinking and offers plenty of opportunity to do great work.

Imagine a career at one of the nation's most advanced health networks.

Be part of an exceptional health care experience. Join the inspired, passionate team at Lehigh Valley Health Network, a nationally recognized, forward-thinking organization offering plenty of opportunity to do great work.

LVHN has been ranked among the "Best Hospitals" by U.S. News & World Report for 23 consecutive years. We're a Magnet(tm) Hospital, having been honored five times with the American Nurses Credentialing Center's prestigious distinction for nursing excellence and quality patient outcomes in our Lehigh Valley region. Finally, Lehigh Valley Hospital - Cedar Crest, Lehigh Valley Hospital - Muhlenberg, Lehigh Valley Hospital- Hazleton, and Lehigh Valley Hospital - Pocono each received an 'A' grade on the Hospital Safety Grade from The Leapfrog Group in 2020, the highest grade in patient safety. These recognitions highlight LVHN's commitment to teamwork, compassion, and technology with an unrelenting focus on delivering the best health care possible every day.

Whether you're considering your next career move or your first, you should consider Lehigh Valley Health Network.

Develops, implements, and maintains a coding and reimbursement quality management plan at the network level. Trains and educates coding and clinical staff. Serves as a coding resource for the organization. Utilizes output for financial and billing purposes to meet licensure requirements, network quality initiatives, and public hospital and physician reporting.

Job Duties

• Performs coding, monitoring, and auditing activities providing individual, departmental, and topic related results according to established schedule.
• Conducts formal education and training for staff on policies/procedures, coding guidelines, regulatory requirements, and work processes. Provides feedback and develops educational action plans.
• Establishes, implements, and maintains a formalized review process to support coding compliance.
• Supports the manager in ensuring the completion of training of new employees and ongoing training of current employees.
• Researches and responds to questions from the coding staff.
• Evaluates the quality of clinical documentation to spot incomplete or inconsistent documentation impacting code selection. Anticipates documentation issues in response to upcoming regulatory updates.
• Maintains database for internal reporting of quality outcomes.
• Demonstrates a clear understanding of purpose and objectives of department by keeping alert on current practices through journals, networking, and continuing education.

• High School Diploma/GED
• 4 years of experience in coding/abstracting of complex patient encounters.
• Microsoft Office and presentation skills.
• Medical terminology, anatomy and physiology, pathophysiology, regulatory agency requirements, severity of illness classification, and health care statistics computation.
• Knowledge of ICD-10-CM/PCS, HCPCs/CPT, modifiers, charge applications, and reimbursement methodologies (DRG, APC).
• Demonstrated leadership and presentation skills.
• CCA - Certified Coding Associate AHIMA - State of Pennsylvania Upon Hire
• CCS - Certified Coding Specialist AHIMA - State of Pennsylvania
• CCS-P - Certified Coding Specialist-Physician Based AHIMA - State of Pennsylvania
• CPC - Certified Professional Coder - State of Pennsylvania
• CPC-H-Certified Professional Coder-Hospital AAPC - State of Pennsylvania

• Associate's Degree in healthcare related field.

Lift and carry 7 lbs., continuous sitting >67%, frequent keyboard use/repetitive motion, frequent fine motor activity/wrist position deviation.

Job Description Disclaimer: This position description provides the major duties/responsibilities, requirements and working conditions for the position. It is intended to be an accurate reflection of the current position, however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require.

Lehigh Valley Health Network is an equal opportunity employer. In accordance with, and where applicable, in addition to federal, state and local employment regulations, Lehigh Valley Health Network will provide employment opportunities to all persons without regard to race, color, religion, sex, age, national origin, sexual orientation, gender identity, disability or other such protected classes as may be defined by law. All personnel actions and programs will adhere to this policy. Personnel actions and programs include, but are not limited to recruitment, selection, hiring, transfers, promotions, terminations, compensation, benefits, educational programs and/or social activities.

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