13 Nov
|
GMM Billing solutions
|
Chennai
13 Nov
GMM Billing solutions
Chennai
Job Name
Senior Medical Coder – Hospital Inpatient DRG
Job Title
Senior Medical Coder – Hospital Inpatient DRG
Experience Required
Experience: Minimum 5+ years Domain: US Hospital Inpatient Coding Core Expertise: ICD-10-CM, ICD-10-PCS, MS-DRG, CC/MCC, and POA indicators. Preferred Certifications -AAPC – CIC (Certified Inpatient Coder).
Candidate Requirement
1.Review and analyze complete hospital inpatient medical records, including History and Physicals, Discharge Summaries, Operative Reports, Progress Notes, Consultation Reports, and Diagnostic Reports. 2.Assign accurate ICD-10-CM diagnosis codes and ICD-10-PCS procedure codes based on clinical documentation. 3.Identify and sequence the Principal Diagnosis in accordance with official inpatient coding guidelines. 4.Assign appropriate secondary diagnosis codes, including relevant comorbidities and complications. 5.Determine accurate MS-DRG assignments based on principal diagnosis, secondary diagnoses, procedures, and applicable DRG grouping criteria. 6.Identify and validate CC (Complications and Comorbidities) and MCC (Major Complications and Comorbidities). 7.Apply Present on Admission (POA) indicators accurately. 8.Review complex medical and surgical inpatient cases and ensure appropriate code assignment. 9.Identify documentation gaps, inconsistencies, and opportunities for Clinical Documentation Improvement (CDI).
10.Raise appropriate physician queries in accordance with compliant query guidelines. 11.Review coding-related denials, DRG downgrades, and audit findings and implement corrective actions. 12.Ensure compliance with ICD-10-CM/PCS Official Guidelines, CMS regulations, and applicable coding standards. 13.Maintain required productivity, quality, and turnaround-time benchmarks. 14.Stay updated on annual ICD-10-CM/PCS code changes, MS-DRG updates, and regulatory requirements. 15.Support internal quality audits, coding education, and process improvement initiatives.
Educational Qualification
Bachelor's degree in Life Sciences or a related field Preferred Certifications -AAPC – CIC (Certified Inpatient Coder).
Technical Qualification
•Robust knowledge of ICD-10-CM and ICD-10-PCS coding. •Hands-on experience with MS-DRG assignment and validation. •Thorough understanding of principal diagnosis selection and sequencing guidelines. •Expertise in CC/MCC identification and validation. •Knowledge of POA indicators and inpatient reporting requirements. •Understanding of surgical procedures and ICD-10-PCS root operations. •Knowledge of sepsis, respiratory failure, acute kidney injury, complications, and other complex inpatient coding scenarios. •Experience with DRG validation, clinical documentation review, and coding audits. •Familiarity with coding encoder tools and hospital billing systems
📌 Senior Medical Coder – Hospital Inpatient DRG (Chennai)
🏢 GMM Billing solutions
📍 Chennai