Client Partner

3 weeks ago

Pune, Maharashtra, India Access Healthcare Full time
Job Description

We are seeking a highly skilled and experienced Client Partner - Medical Coding with a specialization in Inpatient (IP/DRG) Coding. This role is crucial for ensuring the accuracy and compliance of medical coding practices, ultimately supporting revenue integrity for our clients. The ideal candidate will possess deep expertise in inpatient coding methodologies, a strong understanding of regulatory guidelines, and a commitment to continuous improvement and high-quality deliverables.

Key Responsibilities:

- Maintain comprehensive working knowledge of CPT-4, ICD-10-CM, and ICD-10-PCS coding principles, governmental regulations, UHDDS (Uniform Hospital Discharge Data Set) guidelines, AHA coding clinic updates, and third-party requirements regarding coding and documentation.
- Demonstrate proficient knowledge of the Physician Query process and the ability to formulate compliant physician queries in accordance with OIG and UHDDS regulations.
- Exhibit in-depth knowledge of MS-DRG (Medicare Severity Diagnosis Related Groups), MDC (Major Diagnostic Categories), AP-DRG (All Patient DRGs), and APR-DRG (All Patient Refined DRGs), with proven hands-on experience in handling MS-DRG cases.
- Understand the significance of CC (Complication or Comorbidity) and MCC (Major Complication or Comorbidity) when utilized as secondary diagnoses.
- Possess understanding and exposure to Clinical Documentation Improvement (CDI) programs, working in tandem with MS-DRG initiatives.
- Review inpatient and observation medical records to accurately determine and assign diagnosis (ICD-10-CM) codes and procedure (ICD-10-PCS and CPT) codes with appropriate modifiers. Promptly report any deviations identified.
- Maintain a consistently high level of productivity and quality in all coding assignments.
- Achieve established coding targets and collaborate effectively with the team to meet set Turnaround Time (TAT) while maintaining an elevated level of accuracy.
- Deliver an internal accuracy of 95%, meet all turnaround time requirements, and adhere to productivity standards set internally for each specialty.
- Focus on continuous improvement by actively participating in projects aimed at arresting revenue leakage for customers while ensuring full compliance with industry standards.
- Commit to updating coding skills and knowledge through active participation in coding team meetings and educational conferences.
- Conduct periodic refresher training programs within the organization to enhance team capabilities.
- Maintain a high degree of professional and ethical standards in all aspects of work.

Qualifications:

- 1 to 4 years of hands-on experience in Medical Coding, specifically within an inpatient hospital setting.
- Candidates holding CCS (Certified Coding Specialist) or CIC (Certified Inpatient Coder) credentials with hospital coding experience are highly preferred.
- Good knowledge of Medical Coding and billing systems, medical terminologies, regulatory requirements, auditing concepts, and principles.
- Hands-on experience with Encoder tools specific to Hospital coding, such as 3M, Trucode, etc., is preferred.
- Demonstrated reasonable comprehension and analytical skills as a prerequisite for reviewing complex medical documentation and delivering accurate coding.

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