Medical Coder – Inpatient DRG

Medical Coder Inpatient DRG (IPDRG)

Medical Coder Inpatient DRG (IPDRG) Job Summary

The Medical Coder Inpatient DRG (IPDRG) is responsible for accurately reviewing and coding inpatient medical records to determine principal and secondary diagnoses and procedures. The role ensures correct assignment of MS-DRGs APR DRGs POA status Severity of Illness (SOI) Risk of Mortality (ROM) and identification of HACs and PSIs to support accurate hospital reimbursement and quality reporting.

The position requires strong expertise in ICD-10-CM/PCS coding guidelines AHA Coding Clinic references and CMS regulations. The coder analyzes clinical documentation using EMR systems (e.g. Epic Cerner Meditech) and encoder tools to ensure compliant and precise code assignment.

Key responsibilities include reviewing inpatient records for clinical validation working with physicians and Clinical Documentation Specialists (CDS) through compliant queries resolving documentation gaps and supporting denial prevention and revenue integrity. The role also collaborates with HIM and billing teams to resolve coding-related reimbursement and claims issues.

The coder must consistently meet productivity and quality standards while maintaining HIPAA compliance ethical coding practices and adherence to federal and organizational guidelines.

Key Requirements Summary

• Experience: 2 years Inpatient DRG coding
• Certification: CCS or CIC (CDIP acceptable)
• Education: BS Allied Health (preferred: RN/USRN/PHRN Masters)
• Knowledge: ICD-10-CM/PCS MS-DRG/APR DRG SOI/ROM HAC/PSI
• Tools: Epic Cerner Meditech; encoder tools (3M Encoder Pro Codify preferred)
• Skills: Strong analytical thinking attention to detail independent decision-making and excellent English communication (B2)