Coder

Access Healthcare; Dadri, New Delhi; On-site; INR 500,000 - 900,000; Full time

Job summary

Access Healthcare in India seeks a Medical Coder to accurately assign DRG codes to inpatient records using ICD-10-CM/PCS, reflecting diagnoses, procedures and care complexity.

You will review medical records with physicians, ensure coding reflects CMS and payer guidelines, stay current with coding changes, and collaborate with the billing team to resolve issues and ensure timely claims processing.

Qualifications

• Experience in medical coding and DRG assignment.
• Knowledge of ICD-10-CM/PCS coding systems.
• Familiarity with CMS guidelines and payer policies.
• Strong documentation analysis and communication skills.

Responsibilities

• Assign DRG codes to inpatient records using ICD-10-CM/PCS coding systems based on clinical documentation and physician notes.
• Review medical records to verify diagnoses, procedures, and treatments and clarify documentation when needed.
• Apply DRG methodology to ensure accurate assignment based on SOI/ROM and payer requirements.
• Stay updated with coding guidelines and ICD-10-CM/PCS changes and industry updates.
• Collaborate with billing to resolve coding issues and ensure timely inpatient claims processing.

Skills

Medical coding accuracy

ICD-10-CM/PCS knowledge

CMS/payer guidelines

Documentation analysis

Physician communication

Education

Associates degree in health information management or medical coding

Job description

Role & responsibilities

• Assign DRG Codes: Accurately assign DRG codes to inpatient records using ICD-10-CM/PCS coding systems based on clinical documentation and physician notes. Ensure codes reflect the correct diagnosis, procedures, and the overall complexity of care.
• Clinical Documentation Review: Review and analyze medical records to verify diagnoses, procedures, and treatments. Work with physicians and healthcare providers to clarify and improve clinical documentation when needed for proper coding.
• DRG Assignment: Utilize the DRG methodology to ensure accurate and consistent DRG assignment based on the severity of illness (SOI) and risk of mortality (ROM), among other factors. Apply coding conventions and guidelines as per CMS (Centers for Medicare & Medicaid Services) and payer requirements.
• Continuous Education: Keep up to date with coding guidelines, coding technology, and industry changes related to DRGs, including changes in ICD-10-CM/PCS, federal regulations, and insurance payer policies.
• Billing Support: Work closely with the billing department to resolve coding issues and ensure that all claims are processed correctly and promptly for reimbursement. Ensure timely submission of all inpatient claims for accurate payment processing.

Preferred candidate profile

Any Graduate; associates degree in health information management, Medical Coding, or a related field preferred