Client Partner

6 months ago

Chennai, India Access Healthcare Services Full time
Job Description

  • Maintains a 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 guidelines

  • Knowledge of Physician query process and ability to write physician queries in compliance with OIG and UHDDS regulations.

  • Knowledge of MS-DRG (Medicare Severity Diagnosis Related Groups), MDC (Major Diagnostic Categories), AP-DRG (All Patient DRGs), APR-DRG (All Patient Refined DRGs) with hands-on experience in handling MS-DRG

  • Knowledge of CC (complication or comorbidity) and MCC (major complication or comorbidity) when used as a secondary diagnosis

  • Understanding and exposure to Clinical Documentation Improvement (CDI) program to work in tandem with MS-DRG

  • Hands-on experience in any Encoder tools specific to Hospital coding, such as 3M, Trucode, etc., is preferred.

  • The coders assigned on the project would be reviewing Inpatient and observation medical records, determining and assigning accurate diagnosis (ICD-10-CM) codes and Procedure codes (ICD-10-PCS and CPT) codes with appropriate modifiers in addition to reporting any deviations promptly

  • Maintains a high level of productivity and quality

  • Achieve the set targets and cooperate with the respective team in achieving the set Turnaround Time, keeping an elevated level of accuracy

  • We will screen the coders for reasonable comprehension and analytical skills as a prerequisite for reviewing the medical documentation and delivering accurate Coding.

  • The coders must deliver an internal accuracy of 95%, meet the turnaround time requirements, and meet the productivity standards set internally per the specialty

  • Maintains a high degree of professional and ethical standards

  • Focuses on continuous improvement by working on projects that enable customers to arrest revenue leakage while complying with the standards

  • Focuses on updating coding skills and knowledge by participating in coding team meetings and educational conferences.

  • Conducts refresher training programs periodically within the organization

Qualifications

To be considered for this position, applicants need to meet the following qualification criteria:

  • 1 to 4 years of experience in Medical Coding

  • Candidates holding CCS/CIC with hospital coding experience are preferable.

  • Good knowledge of Medical Coding and billing systems, medical terminologies, regulatory requirements, auditing concepts, and principles

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