IP Medical Coder

2 days ago

Pasig, National Capital Region, Philippines Divergence Hr Consulting Group Inc Full time $60,000 - $80,000 per year
About the job IP Medical Coder

Job Summary: The Inpatient Medical Coder is responsible for reviewing and accurately assigning medical codes for inpatient services based on documentation, ensuring compliance with ICD-10-CM, ICD-10-PCS, CPT, HCPCS, and payer guidelines. This role plays a critical part in the revenue cycle process by optimizing reimbursement and minimizing claim denials. The ideal candidate should have strong attention to detail, a deep understanding of medical terminology, and expertise in coding regulations.

Key Responsibilities:

  • Review and analyze inpatient medical records.
  • Ensure coding compliance with AAPC, AHIMA, CMS, and payer-specific guidelines.
  • Abstract and validate clinical information to support accurate coding and billing.
  • Identify and resolve coding discrepancies, providing clarification when needed.
  • Collaborate with physicians, clinical staff, and billing teams to ensure accurate documentation.
  • Assist in denials management, reviewing claim rejections, and submitting appeals when necessary.
  • Maintain confidentiality and ensure compliance with HIPAA regulations.
  • Stay updated with coding changes, regulatory updates, and industry best practices.
  • Participate in internal coding audits and quality assurance to maintain high accuracy levels.

Qualifications & Skills:

  • Active medical coding certification (e.g., CCS, CPC, CIC, RHIT, RHIA) from AAPC or AHIMA.
  • 3-5 years of inpatient coding experience in a hospital or healthcare BPO setting.
  • Strong knowledge of ICD-10-CM, ICD-10-PCS, DRG, CPT, HCPCS, and medical necessity guidelines.
  • Experience with Electronic Health Records (EHR), hospital billing systems, and coding software.
  • Familiarity with payer guidelines, reimbursement methodologies, and appeals processes.
  • Strong analytical skills with attention to detail and accuracy.
  • Ability to work independently in a fast-paced, high-volume environment.
  • Excellent written and verbal communication skills.

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