Ipdrg Medical Coder

Optum; Hyderabad; On-site; INR 450,000 - 750,000; Full time

Job summary

Optum is seeking an Inpatient Coder to accurately code professional services from medical records in hospital or clinic settings, using ICD-10-CM/PCS with appropriate modifiers, in line with official guidelines.

Under supervision, you will review records, assign codes, maintain HIPAA confidentiality, and contribute to quality and productivity in a fast-paced team environment.

Qualifications

• Must have 1–5 years multispecialty IP DRG coding experience.
• Experience in a level I trauma center or teaching hospital with complex procedures.
• ICD-10-CM/PCS coding experience and DRG awareness.

Responsibilities

• Identify ICD-10-CM/PCS codes for inpatient services and assess CC/MCC impact on DRG.
• Abstract additional data elements during chart review as needed.
• Adhere to AAPC/AHIMA ethics and guidelines.
• Code 1.5–2.5 charts per hour while maintaining quality criteria.
• Track and implement updates to AHA guidelines.
• Provide feedback to providers and query physicians when appropriate.
• Maintain up-to-date coding knowledge via QM Manager and coding leadership.
• Participate in coding dept. meetings and educational events.
• Review and maintain records of coded, held, and missing charts.
• Work as a team player to improve quality and productivity.
• Organize and prioritize work to ensure compliant coding timelines.
• Ensure confidentiality and security per HIPAA policies.

Skills

Inpatient coding

ICD-10-CM

ICD-10-PCS

HIPAA compliance

Education

Life Science or Allied Medicine graduates with AAPC/AHIMA certification

Job description

JOB DESCRIPTION: Under direct supervision, the Inpatient Coder is responsible for accurate coding of the professional services (diagnoses, procedures, and modifiers) from medical records in a hospital/clinic setting. Analyzing the medical record, assigning ICD-10-CM, and ICD-10-PCS codes with appropriate modifiers. Medical coding is performed in accordance with the rules, regulations and coding conventions of ICD-10-CM Official Guidelines for Coding and Reporting, ICD-10-PCS guidelines for reporting surgical services, Coding Clinic articles published by the American Hospital Association, and Client Coding Guidelines.

EXPERIENCE

Minimum 1 to 5 years in multispecialty IP DRG coding.

EDUCATIONAL QUALIFICATION

Life Science or Allied Medicine Graduates with certification from AAPC or AHIMA. CIC certification preferred.

PROFESSIONAL QUALIFICATION

• 3+ years of Acute Care Inpatient medical coding experience (hospital, facility, etc.)
• Experience with working in a level I trauma center and / OR teaching hospital with a mastery of complex procedures, major trauma ER encounters, cardiac catheterization, interventional radiology, orthopedic and neurology cases, and observation coding
• ICD - 10 (CM & PCS) and DRG coding experience

ROLES AND RESPONSIBILITIES:

• Identify appropriate assignment of ICD - 10 - CM and ICD - 10 - PCS Codes for inpatient services provided in a hospital setting and understand their impact on the DRG with reference to CC / MCC, while adhering to the official coding guidelines and established client coding guidelines of the assigned facility
• Abstract additional data elements during the Chart Review process when coding, as needed
• Adhere to the ethical standards of coding as established by AAPC and / or AHIMA
• Ability to code 1.5-2.5 charts per hour and meeting the standards for quality criteria.
• Needs to constantly track and implement all the updates of AHA guidelines.
• Provide documentation feedback to providers and query physicians when appropriate
• Maintain up - to - date Coding knowledge by reviewing materials disseminated / recommended by the QM Manager, Coding Operations Managers, and Director of Coding / Quality Management, etc
• Participate in coding department meetings and educational events
• Review and maintain a record of charts coded, held, and / or missing
• An ideal team player who can work in a large group and provide inputs to the team for betterment of the team in terms of quality and productivity.
• Under general supervision, organizes and prioritizes all work to ensure that records are coded and edits are resolved in a timeframe that will assure compliance with regulatory and client guidelines.
• Adherence with confidentiality and maintains security of systems. Compliance with HIPAA policies and procedures for confidentiality of all patient records.
• Demonstrates knowledge of security of systems and associated policies and procedures for maintaining the security of the data contained within the systems.