Medical Coder Inpatient DRG OnsiteDayshiftBGCUp to 120K

We are hiring for a Medical Coder - Inpatient DRG (IPDRG) for a client based in BGC Taguig.

This is an Onsite work following a Dayshift schedule.

Salary is up to 120000.00 based on experience.

Main Requirements:

• Coding Experience: At least 2 years of Inpatient DRG Coding experience.
• Education: Bachelor of Science in the allied health field.
• Credential/Certification: ActiveCertified Coding Specialist (CCS) or Certified Inpatient Coder (CIC) or Certified Documentation Improvement Practitioner (CDIP)
• RCM Knowledge: Extensive comprehensive working knowledge of medical terminology Anatomy and Physiology diagnostic and procedural coding and MS-DRG APR DRG assignment. Must be proficient in identifying POA SOI and ROM indicators for Inpatient records as well as HACs and PSIs to ensure accurate hospital reimbursement. Familiarity with HIPAA regulations.
• Software Knowledge: Proficiency with electronic medical records (EMR) such as Epic Cerner or Meditech.
• Excellent verbal and written English communication skills and customer service skills (CEFR level of at least B2 for both verbal and written)

Preferred skills/expertise

• Education: Masters degree or credential in business healthcare or related field preferred
• Licensure: Registered Nurse with an active PHRN or USRN license preferred.
• Software Knowledge: Current experience utilizing encoding/grouping software and Computer Assisted Coding (CAC) is preferred. Encoder experience (3M/Solventum Encoder Pro Codify) preferred. Proficiency with the Microsoft Office suite (Excel Word PowerPoint Outlook SharePoint). Proficiency with Microsoft Office suite (Excel Word PowerPoint Outlook SharePoint)
• RCM Knowledge: Prior experience with US healthcare providers or payers.

Other Requirements:

• Ability to pay close attention to details; strong follow-up and follow-through skills
• Regularly makes complex decisions within the scope of the position and comfortable working independently
• Requires the use of independent judgment discretion and decision-making abilities
• Demonstrates teamwork and integrity in all work-related activities
• Ability to interact with internal and external customers in a professional manner
• Strong analytical and critical thinking skills.
• Experience in a matrixed environment
• Excellent English written and verbal communication skills

Responsibilities:

Documentation Review and Code Assignment

• Assign appropriate code(s) by utilizing coding guidelines established by:
  • The Centers for Disease Control (CDC) ICD-CM Official Coding Guidelines for Coding and Reporting Centers for Medicare/Medicaid Services (CMS) ICD-PCS Official Guidelines for Coding and Reporting
  • American Hospital Association (AHA) Coding Clinic for International Classification of Diseases Clinical Modification
  • American Health Information Management Association (AHIMA) Standards of Ethical Coding
  • Revenue Excellence/HM coding procedures and guidelines
• Navigate the patient health record and other computer systems/sources to accurately determine diagnosis and procedure codes MS-DRGs APR DRGs and identify HACs and PSIs or other indicators that could impact quality data and hospital reimbursement.
• Code Inpatient health records utilizing encoder software and consistently uses online tools to support the coding process and references to assign ICD codes MS-DRG APR DRGs POA SOI & ROM indicators.
• Review Inpatient health record documentation as part of the coding process to assess the presence of clinical evidence/indicators to support diagnosis code and MS-DRG APR DRG assignments to potentially decrease denials.
• Work on inpatient claim edits and may code consecutive/combined accounts to comply with the 72-hour rule and other account combine scenarios.
• Adhere to the Inpatient coding quality and productivity standards established by the organization.
• Safeguard patient health information in compliance with HIPAA standards.

Query Management & Follow-Up

• Demonstrate knowledge of current compliant coder query practices when consulting with physicians Clinical Documentation Specialists (CDS) or other healthcare providers when additional information is needed for coding and/or to clarify conflicting or ambiguous documentation.
• Utilize EMR communication tools to track missing documentation or Inpatient queries that require follow-up to facilitate coding in a timely fashion.

HIM Collaboration

• Work with HIM and Patient Financial Services (PFS) teams when needed to help resolve billing claims denial and appeals issues affecting reimbursement.