Confidential Jobs_PP
Summary
Our award-winning client is seeking a skilled and experienced
Inpatient Coder
to join their health information management team. The primary goal of this position is to ensure the
integrity and accuracy
of inpatient medical record coding and subsequent billing claims. As an Inpatient Coder, you will perform comprehensive chart reviews to assign accurate ICD-10-CM/PCS codes, ensure compliance with official coding guidelines, and ultimately secure appropriate reimbursement through precise DRG assignment. This role requires
expert knowledge
in complex coding principles, clinical documentation requirements, and regulatory standards.
Responsibilities
Accurate Code Assignment:
Conduct comprehensive analysis and review of complex inpatient medical records to accurately assign the principal diagnosis, secondary diagnoses, and all procedures utilizing ICD-10-CM and ICD-10-PCS classification systems. DRG Validation & Compliance:
Ensure strict adherence to the
Official Coding and Reporting Guidelines
to validate that the assigned codes result in the most accurate and appropriate
MS-DRG
and/or
APR-DRG
for billing purposes. Medical Record Review:
Perform detailed and timely reviews of clinical documentation to confirm that it fully supports all coded diagnoses and procedures. Identify and query physicians for clarification on incomplete, inconsistent, or ambiguous documentation. Error Prevention & Quality Improvement:
Minimize coding errors through diligent review and application of coding rules. Identify documentation trends and suggest process improvements to enhance overall clinical documentation quality and coder efficiency. Collaboration:
Effectively consult and collaborate with clinical documentation specialists (CDS), physicians, and other care team members to ensure documentation integrity and resolve complex coding scenarios. Workflow Management:
Manage, prioritize, and organize a full inpatient coding workload, demonstrating the ability to independently meet high productivity and quality standards. Professional Development:
Attend all mandatory departmental team meetings, training sessions, and remain current on changes to coding guidelines, regulatory mandates, and hospital policies. Other Duties:
Complete additional tasks or special projects as assigned by leadership.
Required Qualifications
Experience:
A minimum of
3 years of recent, acute care inpatient coding experience
in a hospital setting. Coding Certification (Mandatory):
Must possess and maintain the
Certified Coding Specialist (CCS)
credential from AHIMA as a condition of employment. Expert Knowledge:
Demonstrated expertise in applying
ICD-10-CM and ICD-10-PCS
classification systems, Official Coding Guidelines, and comprehensive knowledge of DRG methodologies (MS-DRG and APR-DRG).
Preferred Skills
Prior experience with computer-assisted coding (CAC) software and abstracting systems. Experience coding a wide range of inpatient cases, including complex medical and surgical specialties.
Our award-winning client is seeking a skilled and experienced
Inpatient Coder
to join their health information management team. The primary goal of this position is to ensure the
integrity and accuracy
of inpatient medical record coding and subsequent billing claims. As an Inpatient Coder, you will perform comprehensive chart reviews to assign accurate ICD-10-CM/PCS codes, ensure compliance with official coding guidelines, and ultimately secure appropriate reimbursement through precise DRG assignment. This role requires
expert knowledge
in complex coding principles, clinical documentation requirements, and regulatory standards.
Responsibilities
Accurate Code Assignment:
Conduct comprehensive analysis and review of complex inpatient medical records to accurately assign the principal diagnosis, secondary diagnoses, and all procedures utilizing ICD-10-CM and ICD-10-PCS classification systems. DRG Validation & Compliance:
Ensure strict adherence to the
Official Coding and Reporting Guidelines
to validate that the assigned codes result in the most accurate and appropriate
MS-DRG
and/or
APR-DRG
for billing purposes. Medical Record Review:
Perform detailed and timely reviews of clinical documentation to confirm that it fully supports all coded diagnoses and procedures. Identify and query physicians for clarification on incomplete, inconsistent, or ambiguous documentation. Error Prevention & Quality Improvement:
Minimize coding errors through diligent review and application of coding rules. Identify documentation trends and suggest process improvements to enhance overall clinical documentation quality and coder efficiency. Collaboration:
Effectively consult and collaborate with clinical documentation specialists (CDS), physicians, and other care team members to ensure documentation integrity and resolve complex coding scenarios. Workflow Management:
Manage, prioritize, and organize a full inpatient coding workload, demonstrating the ability to independently meet high productivity and quality standards. Professional Development:
Attend all mandatory departmental team meetings, training sessions, and remain current on changes to coding guidelines, regulatory mandates, and hospital policies. Other Duties:
Complete additional tasks or special projects as assigned by leadership.
Required Qualifications
Experience:
A minimum of
3 years of recent, acute care inpatient coding experience
in a hospital setting. Coding Certification (Mandatory):
Must possess and maintain the
Certified Coding Specialist (CCS)
credential from AHIMA as a condition of employment. Expert Knowledge:
Demonstrated expertise in applying
ICD-10-CM and ICD-10-PCS
classification systems, Official Coding Guidelines, and comprehensive knowledge of DRG methodologies (MS-DRG and APR-DRG).
Preferred Skills
Prior experience with computer-assisted coding (CAC) software and abstracting systems. Experience coding a wide range of inpatient cases, including complex medical and surgical specialties.