About Us:

OptiClaim Business Solutions is a leading provider of healthcare reimbursement and medical coding services. We are committed to excellence in our field, ensuring accurate, effective, and compliant billing practices. Join our dynamic team of professionals and contribute to our mission of delivering top-notch coding solutions to our clients.

Position Overview:

We are seeking an experienced Medical Coder/Senior Medical Coder – IPDRG for a facility setting. The ideal candidate will be proficient in inpatient facility coding, specifically related to IPDRG, and possess experience with UB-04 (Uniform Billing Form 4) for billing purposes. The candidate should also be familiar with ICD-10-PCS codes and G-codes used for inpatient procedures. You will play a crucial role in ensuring accurate and efficient coding and billing practices.

Key Responsibilities:

- Chart Review: Expertly analyze medical charts to accurately assign CPT, ICD-10, ICD-10-PCS, and G-codes for inpatient diagnoses and procedures.
- DRG Assignment: Accurately assign Diagnosis Related Groups (DRGs) for inpatient services to ensure proper reimbursement.
- Compliance: Ensure coding practices adhere to the latest coding standards, regulatory requirements, and customer-specific guidelines.
- Billing Support: Utilize UB-04 forms for accurate billing and support revenue cycle management.
- Accuracy: Maintain a coding accuracy rate of over 97% for inpatient charts, ensuring high-quality and timely code assignments.
- Guideline Proficiency: Stay updated with the latest CPT, ICD-10, ICD-10-PCS, and G-code guidelines to ensure accurate code assignment and perform necessary edits per correct coding initiative.
- Team Collaboration: Work synergistically with the coding team to meet and exceed quality and productivity standards.
- Support Functions: Provide expert support to billers and AR analysts to resolve coding-related issues and optimize revenue cycle management.
- Professional Development: Actively participate in AAPC local chapter meetings, webinars, and other relevant industry events to stay abreast of industry changes and network with peers.




- Quality Improvement: Proactively identify and address causes of claim denials, continually enhancing coding standards and documentation practices at facility and physician-specific levels.

Common Codes Utilized in IPDRG Medical Coding (Facility Setting):

- CPT Codes:
- 99221-99223: Initial hospital care, per day, for the evaluation and management of a patient.
- 99231-99233: Subsequent hospital care, per day, for the evaluation and management of a patient.
- 90833: Psychotherapy, 30 minutes with patient, when performed with an evaluation and management service.
- 90836: Psychotherapy, 45 minutes with patient, when performed with an evaluation and management service.
- ICD-10 Codes:
- F32.0: Major depressive disorder, single episode, mild.
- F41.1: Generalized anxiety disorder.
- F20.0: Paranoid schizophrenia.
- F31.9: Bipolar disorder, unspecified.
- ICD-10-PCS Codes:
- 001607Z: Bypass Coronary Artery, One Artery from Left Internal Mammary, Open Approach
- 0JH60BZ: Insertion of Pacemaker Lead into Right Atrium, Open Approach
- 5A1955Z: Assistance with Respiratory Ventilation, Less than 24 Consecutive Hours
- G Codes:
- G0176: Activity therapy, such as music, dance, art, or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems.
- G0177: Training and educational services related to the care and treatment of patient's disabling mental health problems per session (45 minutes or more).
- G0406: Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth.
- G0407: Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth.
- G602:



Unlisted procedure, diagnostic radiology (requiring use of equipment and supplies)
- DRG Codes:
- DRG 885: Psychoses.
- DRG 881: Depressive Neuroses.
- DRG 895: Alcohol/Drug Abuse or Dependence without Rehabilitation Therapy.

Candidate Profile:

- Experience: 2 to 5 years of experience in medical coding, with specialized expertise in IPDRG and inpatient facility coding.
- Certifications: CPC, COC, or CCS certifications from AAPC/AHIMA are highly preferred; experienced non-certified coders are also encouraged to apply.
- Billing Knowledge: Proficiency in using UB-04 forms for accurate billing and understanding of revenue cycle management.
- Industry Knowledge: Comprehensive understanding of the US healthcare industry, including regulatory requirements, reimbursement methodologies, and payer-specific guidelines.
- Client-Specific Knowledge: Strong familiarity with client-specific process rules and compliance standards.
- Technical Skills: Proficient in using electronic health record (EHR) systems, coding software, and other relevant healthcare IT tools.
- Soft Skills: Exceptional analytical and problem-solving abilities, meticulous attention to detail, strong communication skills, and the ability to work efficiently in a fast-paced environment.

Why Join Us:

- Innovative Environment: Be part of a forward-thinking organization dedicated to improving healthcare through excellence in medical coding and billing.
- Career Growth: Opportunities for continuous learning and professional development, including support for obtaining and maintaining coding certifications.
- Impactful Work: Play a crucial role in ensuring accurate coding and billing, which directly impacts patient care, billing accuracy, and healthcare quality.

If you are a dedicated medical coding professional passionate about making a difference in the field of inpatient facility coding, we invite you to join our team and contribute to our mission of delivering exceptional healthcare services.

You can either apply directly or mail us your resumes on [email protected]

📌 Senior Medical Coder Inpatient DRG ( IPDRG ) (Nagpur)
🏢 OptiClaim
📍 Nagpur