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Job Description: DRG Coder
Position Summary
The DRG (Diagnosis-Related Group) Coder is responsible for reviewing medical records, assigning accurate diagnostic and procedural codes, and ensuring compliance with coding guidelines to support hospital reimbursement and quality reporting. This role plays a critical part in optimizing revenue cycle management and maintaining data integrity in healthcare operations.
Key Responsibilities
- Review inpatient medical records to assign ICD-10-CM and ICD-10-PCS codes in accordance with official coding guidelines.
- Apply appropriate MS-DRG (Medicare Severity Diagnosis-Related Group) assignments to ensure accurate reimbursement.
- Validate physician documentation and query providers when clarification is needed.
- Ensure compliance with CMS, AHA, and hospital-specific coding policies.
- Collaborate with clinical staff, auditors, and revenue cycle teams to resolve discrepancies.
- Maintain productivity and accuracy standards as defined by the organization.
- Participate in ongoing education and training to stay current with coding updates and regulatory changes.
- Contribute to quality improvement initiatives by providing feedback on documentation practices.
Qualifications
- Education: Bachelor's degree in nursing, Health Information Management, or related field preferred.
- Certification: CPC, CCS, or equivalent coding certification required.
- Experience: Minimum 2–3 years of inpatient coding experience, with strong knowledge of DRG methodology required.
- Proficiency in ICD-10-CM, ICD-10-PCS, and DRG grouping software required.
- Strong analytical skills and attention to detail.
- Excellent communication skills for provider queries and team collaboration.
Preferred Skills
- Familiarity with electronic health record (EHR) systems and coding software.
- Knowledge of Medicare and Medicaid reimbursement methodologies.
- Ability to work independently and meet deadlines in a fast-paced environment.
- Commitment to maintaining confidentiality and compliance with HIPAA regulations.
