Diagnosis Related Group (DRG)
Coordinators perform data quality reviews on inpatient hospital records in
order to validate billing codes. This also includes concurrent reviews of
Medicare inpatients to ensure accurate coding and billing. DRG
coordinators are also responsible for continuously evaluating the quality
of clinical documentation to spot incomplete or inconsistent documentation
for patients that could impact the code selection and resulting payment.
They may also provide or arrange for training of healthcare professionals
in the use of coding guidelines and practices, proper documentation
techniques, medical terminology, and disease processes as it related to
the DRG and other clinical data quality management factors. A major
function of the DRG coordinator is to collect and prepare data that is
used in studies involving inpatient stays for clinical evaluation purposes
and financial impact and profitability. This requires familiarity with a
variety of concepts, practices, and procedures related to this healthcare
specialty. DRG coordinators usually have a number of personnel that work
under them and are responsible for training and directing them. To be
successful as a DRG coordinator, an individual needs to have good
leadership and managerial skills. They should also be well organized, have
good written and oral communication skills, and be attentive to detail.
DRG coordinators work in hospitals, home
health agencies, insurance agencies, consulting firms, government
agencies, outpatient clinics, health care computing industries, long-term
care facilities, and private industries.
High School Preparation:
interested in a career as a DRG coordinator should take courses in
algebra, biology, chemistry, computer skills, data processing, psychology,
English, government, history, literature, foreign language, anatomy,
sociology, and health occupations/medical professions education.
interested in DRG coordination should complete a baccalaureate degree
program from an accredited institution, which is generally 4 years in
length. Graduates are then eligible to take the national certification
examination offered by the American Health Information Management
Association, which is preferred by most employers.
interested in health information administration should contact schools for
information on admission and course of study.
For educational institutions in
offering this course of study click here.
In the years to come, hospitals will
continue to be the highest employer of health information professionals.
There is expected to be a 10% - 20% increase in the number of DRG
coordinators through the year 2012. This is mainly due to the need for
detailed and highly organized medical records that will be increasingly
scrutinized by third party payers, courts, and consumers. Many other
health care facilities such as health maintenance organizations, nursing
homes, and home health agencies will also be utilizing DRG coordinators
because of the need to keep accurate medical records and valuable research
Average Annual Salary
$41,300 - $55,300
American Health Information Management
919 North Michigan Avenue, Suite 1400
Phone: (312) 787-2672
Medical Records Institute
567 Walnut Street
PO Box 289
Newton, MA 02160
Mississippi Health Information
921 North Congress Street
Phone: (601) 956-4105