Inpatient Coding Specialist

2 days ago

Pune, Maharashtra, India beBeeCoding Full time ₹ 15,00,000 - ₹ 28,00,000

Medical Coding Expert

We are seeking a highly skilled and experienced professional with deep expertise in inpatient coding methodologies, regulatory guidelines, 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 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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