Inpatient Coder - Complex DRG ICD-10 Expert

AAPC; United States; On-site; USD 65,000 - 90,000; Full time

Job summary

Hartford HealthCare is seeking an Inpatient Coder to review inpatient clinical documentation and assign ICD-10-CM diagnoses and ICD-10-PCS procedures. You will determine MS-DRG assignments and support regulatory compliance and reimbursement.

Responsibilities include collaborating with CDS and billing teams, applying UHDDS standards, and ensuring adherence to coding guidelines and ethical standards. This role reports to the Inpatient Coding Manager and may involve mentoring newer coders.

Responsibilities

• Applies strong knowledge of anatomy and physiology, clinical disease processes, pharmacology, and diagnostic and procedural terminology to determine the appropriate assignment of diagnosis and procedure codes for more complex accounts.
• Analyzes medical records using UHDDS, interprets documentation and assigns ICD-10-CM diagnoses and ICD-10-PCS codes using designated software including CAC/encoder, coding manuals and reference materials.
• Reviews DRG assigned to each record, enters coded information, analyzes DRG groupings, and observes for correct DRG assignment.
• Handles high-dollar and complex cases including medical, surgical, behavioral health and IP Rehabilitation.
• Applies IRF-PAI guidelines for IP Rehabilitation coding.
• Adheres to department coding procedures, policies, guidelines and quality standards; follows AHIMA/ACPC coding standards.
• Meets revenue cycle goals (KPIs and Productivity Standards).
• Issue Resolution: completes assigned review edits on a daily basis.
• Communication: collaborates with CDS to determine DRG assignments for compliance and reimbursement, works with Billing Registration and other departments, seeks physician clarification when documentation is incomplete or contradictory.
• Training: assists in training and mentoring new coders to acclimate to the environment and internal policies.

Job description

Hartford HealthCare is seeking an Inpatient Coder to review inpatient clinical documentation and assign ICD-10-CM diagnoses and ICD-10-PCS procedures. You will determine MS-DRG assignments and support regulatory compliance and reimbursement.

Responsibilities include collaborating with CDS and billing teams, applying UHDDS standards, and ensuring adherence to coding guidelines and ethical standards. This role reports to the Inpatient Coding Manager and may involve mentoring newer coders.