nOptiClaim 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.
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nRole Overview
nThis 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.
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nKey Responsibilities
nCoding
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- Review inpatient charts and assign ICD-10-CM diagnosis codes and ICD-10-PCS procedure codes.
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- Assign the appropriate DRG for each inpatient stay based on documented diagnoses and procedures.
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- Work assigned inpatient work queues (Low Dollar, High Dollar, On Hold) in priority order
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- Complete charts within the 48-hour TAT, prioritizing older accounts first.
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- Issue provider queries in Cerner when documentation needs clarification (e.g., sepsis, malnutrition, debridement).
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nCDI & Quality
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- Resolve DRG mismatches flagged during CDI review and update coding as needed.
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- Hold accounts for missing documentation (operative reports, pathology reports, CDI queries) and release once resolved.
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- Maintain a coding accuracy rate above 97%.
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- Support internal and external audit reviews; update and rebill accounts where corrections are agreed.
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nMust-Have Expertise
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- ICD-10-CM diagnosis coding and ICD-10-PCS procedure coding for inpatient encounters.
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- DRG assignment and how diagnoses/procedures affect DRG grouping.
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- Familiarity with G-codes used in inpatient coding (e.g., G0176, G0177, G0406, G0407).
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- CDI query response and DRG mismatch resolution.
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- Working knowledge of official coding guidelines (AHA Coding Clinic, CMS DRG definitions).
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- Hands-on experience with 3M (HDM) and Cerner (MAPS Prod).
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- Comfortable working in a hospital-based inpatient (IPDRG) coding environment.
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nQualifications
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- CPC, CCS, or equivalent coding certification preferred; experienced non-certified coders may also apply.
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- 3–5 years of inpatient facility (IPDRG) coding experience.
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- Working knowledge of 3M and Cerner.
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- Comfortable meeting daily production and 48-hour TAT targets.
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nApply directly on the job post or send your resume to