In Patient Coder

JOB DESCRIPTION

In Patient – Coding

JOB SUMMARY

We are seeking an experienced, detail-oriented Inpatient ICD-10-PCS Coder to join our Health Information Management team. The successful candidate will accurately assign ICD-10-PCS procedure codes and ICD-10-CM diagnosis codes for inpatient hospital encounters, ensure correct MS-DRG/APR-DRG assignment, identify reportable conditions (HACs/PSIs), and support documentation improvement and revenue integrity initiatives

KEY RESPONSIBILITIES

• Review inpatient medical records (admission history, progress notes, operative reports, discharge summary, diagnostic reports) to identify reportable diagnoses, procedures, and clinical indicators.
• Assign accurate ICD-10-PCS procedure codes and ICD-10-CM diagnosis codes using Official Coding Guidelines, Coding Clinic guidance, UHDDS rules, and facility policies.
• Validate MS-DRG/APR-DRG assignment and sequence principal diagnosis and procedures correctly to reflect clinical care and support appropriate reimbursement.
• Identify Present on Admission (POA) indicators, hospital-acquired conditions (HACs), patient safety indicators (PSIs), CC/MCC capture, SOI/ROM drivers, and HCC opportunities; escalate issues per policy.
• Perform queries to providers (written/electronic or verbal per policy) when documentation is incomplete, conflicting, or insufficient to assign correct codes or determine POA/complication status.
• Meet individual and team productivity and accuracy targets; participate in quality assurance reviews and accept feedback to improve coding accuracy.
• Adhere to HIPAA standards, hospital policy, and federal billing regulations to reduce claim denials and audit risks
• Provides instruction and feedback to Inpatient Coders regarding proper coding / DRG assignment as necessary
• Maintain current knowledge of ICD-10-CM/PCS updates, Coding Clinic advisories, Medicare and state payer rules, and participate in continuing education.

REQUIRED SKILLS

• In-depth knowledge of ICD-10-PCS procedure structure, root operations, approaches, devices, and qualifiers.
• Accurate DRG/Group assignment and sequencing, understanding of policy impacts on reimbursement and quality metrics.
• Mandatory certification from either AAPC or AHIMA with CIC or CCS certification.
• Strong analytic and critical-thinking skills to resolve ambiguous documentation and complex clinical scenarios.
• Effective provider communication and query-writing skills following facility query policy and coding ethics.
• Attention to detail, time management, and ability to meet productivity and turnaround SLAs while preserving accuracy.
• Proficiency with hospital clinical documentation, operative reports, pathology, radiology, and laboratory reports.
• Familiarity with compliance and regulatory requirements, HIPAA, and ethical coding standards (AHIMA/AAPC).

QUALIFICATIONS & EXPERIENCE

• Active coding credential: CCS (AHIMA) or CIC (AAPC) with significant inpatient experience is mandatory
• Minimum 4–6 years of ICD-10-PCS procedure codes and MS-DRG validation
• Strong knowledge of anatomy, physiology, pharmacology, and medical terminology relevant to inpatient care (surgery, cardiology, orthopedics, neurosurgery, OB/GYN, ICU/critical care).

KEY PERFORMANCE INDICATORS (KPIs).

• Coding Accuracy rate
• Specificity capture rate
• DRG Assignment Accuracy
• Compliance Audit scores
• Turnaround time
• Query Rate
• Missed Query opportunity Rate
• Query compliance Rate
• Charts coded per day
• Documentation – Related Denial rate
  
  Additional Details : 
  Location : Embassy tech village, Kadubeesanahalli, Bellandur Bangalore 
  Shifts : 2:00 PM to 11:00 PM 
  Transport will be given 
  
  Contact person : Shivani@8073921503
  
  All the best.