Medical Coder - Impatient DRG

Ayuda Business Management Solutions Inc.; Taguig; On-site; PHP 334,800 - 558,000; Full time

Job summary

A healthcare solutions provider in Taguig is seeking a Medical Coder - Inpatient with at least 2 years of experience in Inpatient DRG Coding. The role requires expertise in assigning ICD codes, MS-DRG, and familiarity with medical software such as Epic and Cerner. Candidates must hold a Bachelor of Science in an allied health field and possess certifications like CCS or CIC. Excellent English communication skills are essential. Candidates with a Master's degree or nursing licenses are preferred.

Qualifications

• At least 2 years of experience in Inpatient DRG Coding.
• Active Certified Coding Specialist (CCS) or equivalent credentials required.
• Familiarity with HIPAA regulations is essential.

Responsibilities

• Review and assign codes in Inpatient health records.
• Utilize coding guidelines established by recognized organizations.
• Identify Hospital Acquired Conditions (HAC) and Patient Safety Indicators (PSI).

Skills

Inpatient DRG Coding Experience

Medical Terminology

Anatomy and Physiology

Excellent English Communication Skills

Education

Bachelor of Science in allied health field

Tools

Epic

Cerner

Meditech

Job description

Your Role

The Medical Coder-Inpatient DRG (IPDRG) provides high-level technical competency and subject matter expertise in analyzing physician/provider documentation in Inpatient health records to determine the principal diagnosis, secondary diagnoses, principal procedure, and secondary procedures. Assigns appropriate Medicare Severity Diagnosis Related Groups (MS-DRG), All Patient Refined DRGs (APR), Present on Admission (POA), as well as Severity of Illness (SOI) & Risk of Mortality (ROM) indicators for Inpatient records. Identifies Hospital Acquired Conditions (HAC) and Patient Safety Indicators (PSI) to ensure accurate hospital reimbursement.

As a Medical Coder - Inpatient, You Will:

• Documentation Review and Code Assignment
• Assign appropriate code(s) by utilizing coding guidelines established by:
• The Centers for Disease Control (CDC), ICD-CM Official Coding Guidelines for Coding and Reporting, Centers for Medicare/Medicaid Services (CMS) ICD-PCS Official Guidelines for Coding and Reporting
• American Hospital Association (AHA) Coding Clinic for International Classification of Diseases, Clinical Modification
• American Health Information Management Association (AHIMA) Standards of Ethical Coding
• Revenue Excellence/HM coding procedures and guidelines
• Navigate the patient health record and other computer systems/sources to accurately determine diagnosis and procedures codes, MS-DRGs, APR DRGs, and identify HACs and PSIs or other indicators that could impact quality data and hospital reimbursement.
• Code Inpatient health records utilizing encoder software and consistently uses online tools to support the coding process and references to assign ICD codes, MS-DRG, APR DRGs, POA, SOI & ROM indicators.
• Review Inpatient health record documentation, as part of the coding process, to assess the presence of clinical evidence/indicators to support diagnosis code and MS-DRG, APR DRG assignments to potentially decrease denials.

What You Need

Non-negotiables

Coding Experience: At least 2 years of Inpatient DRG Coding experience.

• Education: Bachelor of Science in allied health field.
• Credential/Certification: ActiveCertified Coding Specialist (CCS) or Certified Inpatient Coder (CIC), or Certified Documentation Improvement Practitioner (CDIP)
• RCM Knowledge: Extensive, comprehensive working knowledge of medical terminology, Anatomy and Physiology, diagnostic and procedural coding, and MS-DRG, APR DRG assignment. Must be proficient in identifying POA, SOI, and ROM indicators for Inpatient records as well as HACs and PSIs to ensure accurate hospital reimbursement. Familiarity with HIPAA regulations.
• Software Knowledge: Proficiency with electronic medical records (EMR) such as Epic, Cerner, or Meditech.
• Excellent verbal and written English communication skills and customer service skills (CEFR level of at least B2 for both verbal and written)

Preferred Skills/expertise

• Education: Master’s degree or credential in business, healthcare, or related field preferred
• Licensure: Registered Nurse with an active PHRN or USRN license preferred.
• Software Knowledge: Current experience utilizing encoding/grouping software and Computer Assisted Coding (CAC) is preferred. Encoder experience (3M/Solventum, Encoder Pro, Codify) preferred. Proficiency with Microsoft Office suite (Excel, Word, PowerPoint, Outlook, SharePoint). Proficiency with Microsoft Office suite (Excel, Word, PowerPoint, Outlook, SharePoint)
• RCM Knowledge: Prior experience with US healthcare providers or payers.