Senior Medical Coder – IPDRG

Inpatient Facility DRG Coding

Remote | Night Shift (5:30 PM – 1:30 AM IST)

About Us

OptiClaim Business Solutions provides medical coding and reimbursement services to U.S. healthcare providers, with a dedicated team supporting inpatient (IP) DRG coding. We're hiring experienced coders who bring accuracy to this hospital-based inpatient coding workplace.

Role Overview

This role sits within our Inpatient (IP) DRG coding team, coding hospital inpatient admissions. You'll assign ICD-10-CM diagnosis codes, ICD-10-PCS procedure codes, and the appropriate DRG for each inpatient stay, working inpatient charts in 3M and Cerner, meeting daily TAT targets, and resolving DRG mismatches flagged during CDI review.

Key Responsibilities

Coding

- Review inpatient charts and assign ICD-10-CM diagnosis codes and ICD-10-PCS procedure codes.
- Assign the appropriate DRG for each inpatient stay based on documented diagnoses and procedures.
- Work assigned inpatient work queues (Low Dollar, High Dollar, On Hold) in priority order
- Complete charts within the 48-hour TAT, prioritizing older accounts first.
- Issue provider queries in Cerner when documentation needs clarification (e.g., sepsis, malnutrition, debridement).

CDI & Quality





- Resolve DRG mismatches flagged during CDI review and update coding as needed.
- Hold accounts for missing documentation (operative reports, pathology reports, CDI queries) and release once resolved.
- Maintain a coding accuracy rate above 97%.
- Support internal and external audit reviews; update and rebill accounts where corrections are agreed.

Must-Have Expertise

- ICD-10-CM diagnosis coding and ICD-10-PCS procedure coding for inpatient encounters.
- DRG assignment and how diagnoses/procedures affect DRG grouping.
- Familiarity with G-codes used in inpatient coding (e.g., G0176, G0177, G0406, G0407).
- CDI query response and DRG mismatch resolution.
- Working knowledge of official coding guidelines (AHA Coding Clinic, CMS DRG definitions).
- Hands-on experience with 3M (HDM) and Cerner (MAPS Prod).
- Comfortable working in a hospital-based inpatient (IPDRG) coding environment.

Qualifications

- CPC, CCS, or equivalent coding certification preferred; experienced non-certified coders may also apply.
- 3–5 years of inpatient facility (IPDRG) coding experience.
- Working knowledge of 3M and Cerner.
- Comfortable meeting daily production and 48-hour TAT targets.

Apply directly on the job post or send your resume to [email protected]

📌 Senior Medical Coder – IPDRG (India)
🏢 OptiClaim
📍 India