Medical Coder Inpatient WFH Day Shift

Job Description:

Discover your 100% YOU with MicroSourcing

Position:

Medical Coder - Inpatient DRG (IPDRG)

Location:

BGC, Taguig City

Work setup & shift:

WFH, Day shift (Terms and conditions apply.)

Salary:

Up to 100K

SOB:

Equivalent to 1 month's salary + 50K Terms and conditions apply.

Why join MicroSourcing?

You'll Have

• Competitive Rewards: Enjoy above-market compensation, healthcare coverage on day one, plus one or more dependents, paid time-off with cash conversion, group life insurance, and performance bonuses
• A Collaborative Spirit: Contribute to a positive and engaging work environment by participating in company-sponsored events and activities.
• Work-Life Harmony: Enjoy the balance between work and life that suits you with flexible work arrangements.
• Career Growth: Take advantage of opportunities for continuous learning and career advancement.
• Inclusive Teamwork: Be part of a team that celebrates diversity and fosters an inclusive culture.

Your Role

The Medical Coder-Inpatient DRG (IPDRG) provides high-level technical competency and subject matter expertise in analyzing physician/provider documentation in Inpatient health records to determine the principal diagnosis, secondary diagnoses, principal procedure, and secondary procedures. Assigns appropriate Medicare Severity Diagnosis Related Groups (MS-DRG), All Patient Refined DRGs (APR), Present on Admission (POA), as well as Severity of Illness (SOI) & Risk of Mortality (ROM) indicators for Inpatient records. Identifies Hospital Acquired Conditions (HAC) and Patient Safety Indicators (PSI) to ensure accurate hospital reimbursement.

As a Medical Coder - Inpatient, You Will

Documentation Review and Code Assignment

• Assign appropriate code(s) by utilizing coding guidelines established by:
  • The Centers for Disease Control (CDC), ICD-CM Official Coding Guidelines for Coding and Reporting, Centers for Medicare/Medicaid Services (CMS) ICD-PCS Official Guidelines for Coding and Reporting
  • American Hospital Association (AHA) Coding Clinic for International Classification of Diseases, Clinical Modification
  • American Health Information Management Association (AHIMA) Standards of Ethical Coding
  • Revenue Excellence/HM coding procedures and guidelines
• Navigate the patient health record and other computer systems/sources to accurately determine diagnosis and procedures codes, MS-DRGs, APR DRGs, and identify HACs and PSIs or other indicators that could impact quality data and hospital reimbursement.
• Code Inpatient health records utilizing encoder software and consistently uses online tools to support the coding process and references to assign ICD codes, MS-DRG, APR DRGs, POA, SOI & ROM indicators.
• Review Inpatient health record documentation, as part of the coding process, to assess the presence of clinical evidence/indicators to support diagnosis code and MS-DRG, APR DRG assignments to potentially decrease denials.
• Work on inpatient claim edits and may code consecutive/combined accounts to comply with the 72-hour rule and other account combine scenarios.
• Adhere to the Inpatient coding quality and productivity standards established by the organization.
• Safeguard patient health information in compliance with HIPAA standards.

Query Management & Follow-Up

• Demonstrate knowledge of current, compliant coder query practices when consulting with physicians, Clinical Documentation Specialists (CDS) or other healthcare providers when additional information is needed for coding and/or to clarify conflicting or ambiguous documentation.
• Utilize EMR communication tools to track missing documentation or Inpatient queries that require follow-up to facilitate coding in a timely fashion.

HIM Collaboration

• Work with HIM and Patient Financial Services (PFS) teams, when needed, to help resolve billing, claims, denial, and appeals issues affecting reimbursement.

Coding Knowledge & Expertise

• Maintain CEUs as appropriate for coding credentials as required by credentialing associations.
• Maintain current knowledge of changes in Inpatient coding and reimbursement guidelines and regulations, as well as new applications or settings for Inpatient coding e.g., Hospital at Home.
• Identify and report coding and/or EMR workflow issues to their supervisor.
• Exhibit awareness of health record documentation or other coding ethics concerns. Notifies appropriate leadership for assistance and resolution when appropriate.
• Maintain a working knowledge of applicable coding and reimbursement Federal, State, and local laws and regulations, Code of Ethics, as well as othe