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Job Location: Chennai, India
Job Description - IP/DRG Medical Coders
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
Knowledge of Physician query process and ability to write physician query in compliance with OIG and UHDDS regulations
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
Knowledge of CC (complication or comorbidity) and MCC (major complication or comorbidity) when used as a secondary diagnosis
Understanding and exposure to Clinical Documentation Improvement (CDI) program to work in tandem with MS-DRG
Hands-on experience in any of the Encoder tools specific to Hospital coding such as 3M, Trucode, etc. is preferred
The coders assigned on the project would be reviewing Inpatient and observation medical records, determine and assign accurate diagnosis (ICD-10-CM) codes and Procedure codes (ICD-10-PCS and/or CPT) codes with appropriate modifiers in addition to reporting any deviations in a timely manner
Maintains high level of productivity and quality
Achieve the set targets and cooperate with the respective team in achieving the set Turnaround Time keeping an elevated level of accuracy
The coders would undergo a thorough background check during the hiring process that includes verifying the OIG exclusion database and ensure the coders hired are not part of the OIG exclusion listing that debars them as ineligible to participate in federal and state health programs on the grounds of fraudulent practices identified on historical records
The coders would as well be screened for reasonable comprehension and analytical skills that are considered a prerequisite for reviewing the medical documentation and deliver accurate coding
The coders are expected to deliver an internal accuracy of 95%, meet turnaround time requirements in addition to meeting productivity standards set internally per the specialty
Maintains high degree of professional and ethical standards
Focuses on continuous improvement by working on projects that enables customers to arrest revenue leakage while being in compliance with the standards.
Focuses on updating coding skills, knowledge, and accuracy by participating in coding team meetings and educational conferences. This includes refresher and ongoing training programs conducted periodically within the organization.
To be considered for this position, applicants need to meet the following qualification criteria:
Graduates in life sciences with 1 - 4 years’ experience in Medical Coding
Candidates holding CCS/CIC with hospital coding experience are preferable
The coders as well undergo certifications sponsored by AAPC and AHIMA as they mature with the process. Access health care has now partnered with AAPC to hand hold in-house certification training for its coders and sponsor for the examinations.
Good knowledge of medical coding and billing systems, medical terminologies, regulatory requirements, auditing concepts, and principles