• 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 queries 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 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, determining and assigning accurate diagnosis (ICD-10-CM) codes and Procedure codes (ICD-10-PCS and CPT) codes with appropriate modifiers in addition to reporting any deviations promptly
• Maintains a 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
• We will screen the coders for reasonable comprehension and analytical skills as a prerequisite for reviewing the medical documentation and delivering accurate Coding.
• The coders must deliver an internal accuracy of 95%, meet the turnaround time requirements, and meet the productivity standards set internally per the specialty
• Maintains a high degree of professional and ethical standards
• Focuses on continuous improvement by working on projects that enable customers to arrest revenue leakage while complying with the standards
• Focuses on updating coding skills and knowledge by participating in coding team meetings and educational conferences.
• Conducts refresher training programs periodically within the organization
Qualifications
• 1 to 4 years of experience in Medical Coding
• Candidates holding CCS/CIC with hospital coding experience are preferable.
• Good knowledge of Medical Coding and billing systems, medical terminologies, regulatory requirements, auditing concepts, and principles

Role: Medical Record / Health Informatics
Industry Type: Medical Services / Hospital
Department: Healthcare & Life Sciences
Employment Type: Full Time, Permanent
Role Category: Health Informatics

Education
UG: Any Graduate
PG: Any Postgraduate

Key Skills
BPO Analytical skills Training Medical coding Billing Healthcare medical records Continuous improvement MCC Auditing