Dear Candidates,

Looking for coder opening for surgery,EXL and E/M.

Min - 3 years

Ctc for coder - 9 lakhs - 12 lakhs

quality and AM Lead - 13 lakhs - 15 lakhs

Any certification is mandatory.

Contact Details:

Reach me out Priya Hr (6381133167) or share me ( mohanapriya@covenantindia.net )

Job Title: IP-DRG, Surgery, and E/M Coder

Location: [Insert location]

Department: Coding and Billing

Reports to: [Insert supervisor's title]

FLSA Status: Non-Exempt

Job Summary:

The IP-DRG, Surgery, and E/M Coder will be responsible for accurately coding inpatient (IP) diagnosis-related groups (DRGs), surgeries, and evaluation & management (E/M) services using ICD-10-CM, CPT, and HCPCS coding systems. This position plays a critical role in ensuring accurate documentation, coding, and billing in compliance with applicable laws and regulations, including payer-specific guidelines.

Key Responsibilities:

1. Inpatient DRG Coding:

• Assign appropriate ICD-10-CM codes for inpatient admissions based on physician documentation and clinical information.
• Ensure DRG assignment aligns with clinical data, accurately reflecting the severity of illness (SOI) and risk of mortality (ROM).
• Perform accurate coding for all diagnoses and procedures for inpatient cases in compliance with CMS guidelines.
• Ensure accurate coding of comorbidities and complications (CCs) and major comorbidities and complications (MCCs).

1. Surgical Coding:

• Accurately assign CPT and ICD-10-PCS codes for surgical procedures based on physician notes, operative reports, and other clinical documentation.
• Ensure proper coding of surgical services, including inpatient, outpatient, and ambulatory surgical procedures.
• Stay updated with changes to CPT, ICD-10-PCS, and other relevant codes for surgeries and interventions.

1. Evaluation & Management (E/M) Coding:

• Assign correct E/M codes based on documentation related to physician office visits, hospital visits, consultations, and other related services.
• Ensure compliance with CMS and payer-specific E/M guidelines, including appropriate use of code levels based on history, exam, and medical decision-making (MDM).
• Collaborate with clinical teams to resolve documentation deficiencies and ensure E/M codes reflect the services provided.

1. Documentation Review:

• Review medical records and documentation to ensure completeness, accuracy, and compliance with coding standards.
• Collaborate with physicians and clinical staff to clarify and correct any ambiguous or incomplete documentation.

1. Compliance & Auditing:

• Adhere to federal, state, and payer-specific guidelines to ensure accurate and compliant coding practices.
• Participate in regular internal audits to ensure compliance and minimize risks of coding discrepancies or denials.
• Address and resolve coding errors identified through audits or quality assurance reviews.

1. Communication & Teamwork:

• Work closely with the billing department to resolve coding-related issues, payment discrepancies, and claim rejections.
• Communicate coding guidelines and updates to clinical staff as necessary.
• Provide support and guidance to junior coding staff or other team members as required.

Qualifications:

• Education:
• High School Diploma or GED required.
• Certified Professional Coder (CPC) from AAPC or Certified Coding Specialist (CCS) from AHIMA preferred.
• Additional certifications in inpatient coding (CIC), outpatient coding (COC), or ICD-10-CM/PCS coding preferred.
• Skills:
• Excellent understanding of medical terminology, anatomy, and physiology.
• Strong attention to detail and accuracy.
• Knowledge of medical billing processes and payer requirements.
• Ability to interpret and apply coding guidelines accurately.
• Good communication skills, both written and verbal.
• Proficiency in coding software and electronic health record (EHR) systems.