As an Inpatient (IP) DRG Medical Coder, your role involves accurately assigning diagnostic and procedural codes to inpatient medical records following ICD, CPT, and DRG coding guidelines. Ensuring compliance with DOH regulations and insurance requirements is a crucial aspect of your responsibilities.

Key Responsibilities:

• Review and analyze patient records, including doctors' notes, diagnostic reports, and medical documents to ensure proper documentation of diagnoses and procedures.
• Assign standardized codes using ICD-10-CM, CPT, and E&M systems.
• Determine appropriate DRG for each inpatient case based on clinical data in the medical record.
• Ensure full compliance with DOH regulations and payer-specific guidelines.
• Conduct medical record reviews for completeness and accuracy, clarifying with healthcare providers when necessary.
• Perform coding audits to identify discrepancies and opportunities for improvement.
• Collaborate with the billing department to support accurate claims submissions.
• Maintain coding accuracy by submitting claims with appropriate codes and modifiers.
• Maintain a 97% accuracy rate in internal audits.
• Uphold strict confidentiality in line with DOH guidelines.

Communicate with healthcare providers:

• Clarify information to justify rejected claims or approvals.
• Provide appropriate codes for approval and denial teams, resolving coding-related issues.

Continuing Education:

• Stay updated with changes in coding guidelines, DRG system updates, and healthcare regulations through ongoing professional development.
• Keep abreast of changes in coding standards and regulations.
• Check shafafiya DOH site for updated code sets, Mandatory tariff, and circulars.

Qualifications

• Education: Associate's or Bachelor's degree in Health Information Management or related field.
• Certifications: Preferred certifications such as CCS, CIC, or CPC from AAPC or AHIMA.

Skills

• Strong knowledge of ICD-10-CM, CPT, and DRG coding systems.
• Ability to interpret medical records and clinical terminology.
• Familiarity with coding and billing software, EHR systems, and coding tools.
• Strong analytical and problem-solving skills.
• Excellent communication skills for collaboration with clinical staff. As an Inpatient (IP) DRG Medical Coder, your role involves accurately assigning diagnostic and procedural codes to inpatient medical records following ICD, CPT, and DRG coding guidelines. Ensuring compliance with DOH regulations and insurance requirements is a crucial aspect of your responsibilities.

Key Responsibilities:

• Review and analyze patient records, including doctors' notes, diagnostic reports, and medical documents to ensure proper documentation of diagnoses and procedures.
• Assign standardized codes using ICD-10-CM, CPT, and E&M systems.
• Determine appropriate DRG for each inpatient case based on clinical data in the medical record.
• Ensure full compliance with DOH regulations and payer-specific guidelines.
• Conduct medical record reviews for completeness and accuracy, clarifying with healthcare providers when necessary.
• Perform coding audits to identify discrepancies and opportunities for improvement.
• Collaborate with the billing department to support accurate claims submissions.
• Maintain coding accuracy by submitting claims with appropriate codes and modifiers.
• Maintain a 97% accuracy rate in internal audits.
• Uphold strict confidentiality in line with DOH guidelines.

Communicate with healthcare providers:

• Clarify information to justify rejected claims or approvals.
• Provide appropriate codes for approval and denial teams, resolving coding-related issues.

Continuing Education:

• Stay updated with changes in coding guidelines, DRG system updates, and healthcare regulations through ongoing professional development.
• Keep abreast of changes in coding standards and regulations.
• Check shafafiya DOH site for updated code sets, Mandatory tariff, and circulars.

Qualifications

• Education: Associate's or Bachelor's degree in Health Information Management or related field.
• Certifications: Preferred certifications such as CCS, CIC, or CPC from AAPC or AHIMA.

Skills

• Strong knowledge of ICD-10-CM, CPT, and DRG coding systems.
• Ability to interpret medical records and clinical terminology.
• Familiarity with coding and billing software, EHR systems, and coding tools.
• Strong analytical and problem-solving skills.
• Excellent communication skills for collaboration with clinical staff.