Client Partner - Medical Coding - Inpatient Coding - IP/DRG

Client Partner - Medical Coding

Key Responsibilities:

• Maintain comprehensive working knowledge of

  CPT-4, ICD-10-CM, and ICD-10-PCS coding principles

  , governmental regulations, UHDDS (Uniform Hospital Discharge Data Set) guidelines, AHA coding clinic updates, and third-party requirements regarding coding and documentation.
• Demonstrate proficient knowledge of the

  Physician Query process

  and the ability to formulate compliant physician queries in accordance with OIG and UHDDS regulations.
• Exhibit in-depth knowledge of

  MS-DRG (Medicare Severity Diagnosis Related Groups), MDC (Major Diagnostic Categories), AP-DRG (All Patient DRGs), and APR-DRG (All Patient Refined DRGs)

  , with proven hands-on experience in handling MS-DRG cases.
• Understand the significance of

  CC (Complication or Comorbidity) and MCC (Major Complication or Comorbidity)

  when utilized as secondary diagnoses.
• Possess understanding and exposure to

  Clinical Documentation Improvement (CDI) programs

  , working in tandem with MS-DRG initiatives.
• Review inpatient and observation medical records to accurately determine and assign

  diagnosis (ICD-10-CM) codes

  and

  procedure (ICD-10-PCS and CPT) codes

  with appropriate modifiers. Promptly report any deviations identified.
• Maintain a consistently high level of

  productivity and quality

  in all coding assignments.
• Achieve established coding targets and collaborate effectively with the team to meet set

  Turnaround Time (TAT)

  while maintaining an elevated level of accuracy.
• Deliver an

  internal accuracy of 95%

  , meet all turnaround time requirements, and adhere to productivity standards set internally for each specialty.
• Focus on

  continuous improvement

  by actively participating in projects aimed at arresting revenue leakage for customers while ensuring full compliance with industry standards.
• Commit to updating coding skills and knowledge through active participation in coding team meetings and educational conferences.
• Conduct periodic refresher training programs within the organization to enhance team capabilities.
• Maintain a high degree of

  professional and ethical standards

  in all aspects of work.

Qualifications:

• 1 to 4 years of hands-on experience in Medical Coding

  , specifically within an inpatient hospital setting.
• Candidates holding

  CCS (Certified Coding Specialist) or CIC (Certified Inpatient Coder)

  credentials with hospital coding experience are highly preferred.
• Good knowledge of Medical Coding and billing systems, medical terminologies, regulatory requirements, auditing concepts, and principles.

• Hands-on experience with Encoder tools

  specific to Hospital coding, such as

  3M, Trucode

  , etc., is preferred.
• Demonstrated reasonable comprehension and analytical skills as a prerequisite for reviewing complex medical documentation and delivering accurate coding.