
Healthcare Coding and Quality Assurance Specialist
4 days ago
As a skilled healthcare coding specialist, you will be responsible for reviewing inpatient clinical documentation and assigning accurate ICD-10-CM/PCS codes. You will also assign appropriate MS-DRGs/APR-DRGs based on documented diagnoses and procedures.
To ensure 100% adherence to coding guidelines, payer-specific rules, and DRG logic, you will collaborate with documentation teams to resolve ambiguities and initiate physician queries if needed. Meeting daily productivity and accuracy benchmarks (95%+ accuracy) is also an essential requirement of this role.
- Coding Responsibilities:
- Review inpatient clinical documentation and assign accurate ICD-10-CM/PCS codes.
- Assign appropriate MS-DRGs/APR-DRGs based on documented diagnoses and procedures.
- Quality Assurance Responsibilities:
- Audit inpatient coded charts for accuracy and DRG compliance.
- Provide detailed feedback and corrective training to coders based on audit findings.
To excel in this role, you must have a strong educational background in Life Sciences or Paramedical fields. Additionally, certification as an AAPC or AHIMA Certified CIC, CCS, or CPC-H/COC is mandatory.
- Education:
- Graduate in Life Sciences / Paramedical / Nursing or equivalent
- Experience:
- Coders: Minimum 2 years in inpatient hospital coding
- QA: 3–5 years of inpatient coding + auditing experience
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