Client Partner
4 weeks ago
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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
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Knowledge of Physician query process and ability to write physician queries in compliance with OIG and UHDDS regulations.
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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
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Knowledge of CC (complication or comorbidity) and MCC (major complication or comorbidity) when used as a secondary diagnosis
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Understanding and exposure to Clinical Documentation Improvement (CDI) program to work in tandem with MS-DRG
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Hands-on experience in any Encoder tools specific to Hospital coding, such as 3M, Trucode, etc., is preferred.
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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
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Maintains a high level of productivity and quality
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Achieve the set targets and cooperate with the respective team in achieving the set Turnaround Time, keeping an elevated level of accuracy
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We will screen the coders for reasonable comprehension and analytical skills as a prerequisite for reviewing the medical documentation and delivering accurate Coding.
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The coders must deliver an internal accuracy of 95%, meet the turnaround time requirements, and meet the productivity standards set internally per the specialty
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Maintains a high degree of professional and ethical standards
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Focuses on continuous improvement by working on projects that enable customers to arrest revenue leakage while complying with the standards
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Focuses on updating coding skills and knowledge by participating in coding team meetings and educational conferences.
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Conducts refresher training programs periodically within the organization
To be considered for this position, applicants need to meet the following qualification criteria:
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1 to 4 years of experience in Medical Coding
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Candidates holding CCS/CIC with hospital coding experience are preferable.
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Good knowledge of Medical Coding and billing systems, medical terminologies, regulatory requirements, auditing concepts, and principles
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