DRG Coder

Overview

• Conduct reviews of inpatient claims for coding accuracy and clinical support validation.
• Ensure proper DRG assignment for accurate billing following industry standards.
• Collaborate with physician reviewers and team members as needed.
• Participate in departmental meetings and training sessions regularly.
• Work independently in a remote setting with minimal interruptions.
• Maintain professional credentialed status through approved continuing education programs.
• Contribute to organizational goals by meeting productivity and accuracy expectations.
• Utilize proficiency in relevant software applications for efficient task completion.

Key Responsibilities & Duties

• Analyze inpatient claims to validate ICD-10-CM/PCS codes and ensure compliance.
• Perform comprehensive initial reviews as outlined in standard procedures.
• Collaborate with physician reviewers to address coding and clinical concerns.
• Prioritize and organize workload to meet daily productivity goals.
• Report productivity daily and maintain accuracy in claim reviews.
• Adhere to organizational policies and procedures during work hours.
• Engage in ongoing training and development opportunities provided by the organization.
• Maintain confidentiality and comply with HIPAA regulations in a remote work environment.

Job Requirements

• Associate of Science degree in a relevant field is required.
• Possess at least one certification: CIC, CCS, or RHIT.
• Minimum of 1 year of experience in MS-DRG and APR-DRG coding.
• Proficiency in medical terminology, anatomy, pathophysiology, and pharmacology.
• Strong knowledge of industry standards and regulatory compliance guidelines.
• Proficiency in Outlook, Word, Excel, and other relevant applications.
• Excellent written and verbal communication skills are essential.
• Ability to work independently and manage multiple tasks effectively.
• Access to high-speed internet and a dedicated workspace for remote work.