Inpatient Medical Coder

1 week ago

Gurgaon, Haryana, India Commure Full time ₹ 9,00,000 - ₹ 12,00,000 per year

Inpatient Medical Coder Coding Denials Specialist

Responsibilities

  • Denial Review & Recode

  • Analyse EOB/denial letters/audit findings (RAC/MAC/Commercial); validate MS-DRG/APR-DRG assignment and sequencing.

  • Recode principal/secondary diagnoses and procedures (ICD-10-PCS), verify POA indicators, device/approach specificity, discharge status, and transfer rules.

  • Document rationale citing AHA Coding Clinic, UHDDS, CMS IPPS guidance, and payer policies.

  • Appeal Support

  • Draft coding summaries for level-1/level-2 appeals; compile exhibits (clinical notes, coding references).

  • Track timely filing limits; update payer portals and internal trackers.

  • Clinical Validation & Provider Queries

  • Prevention & Education

  • Trend denials by payer/DRG/reason; recommend edits, query templates, and documentation tips.

  • Maintain SOPs, job aids, and payer playbooks; participate in calibration/QA.

  • Reporting & Compliance

  • Maintain audit-ready notes

  • Stay current on ICD-10 quarterly updates and annual IPPS changes; ensure HIPAA compliance.

Qualifications

  • 2–5 years of inpatient hospital coding experience; 1–3 years of handling coding denials preferred.
  • Deep knowledge of ICD-10-CM/PCS, MS-DRG/APR-DRG, UHDDS, POA/HAC, discharge disposition, and transfer rules.
  • Proven appeal writing/coding rationale experience for DRG, CC/MCC, POA, and PCS denials.
  • Tools: EMR (Epic/Cerner), CAC/Grouper (3M 360/Optum/TruCode), payer portals, Excel/Sheets (lookups/pivots).
  • Strong written communication and attention to detail.

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