Job Overview
The IPDRG Medical Coder analyzes, abstracts, and assigns accurate diagnosis and procedure codes for complex inpatient medical charts. This role ensures proper MS-DRG/APR-DRG determination, maintains regulatory compliance, and optimizes hospital reimbursement accuracy while meeting strict quality and productivity standards.
Key Responsibilities
- Inpatient Chart Abstracting: Thoroughly review medical records—including discharge summaries, operative reports, physician notes, and lab results—to abstract clinical data for inpatient stays.
- Code Assignment: Assign accurate ICD-10-CM (diagnosis) and ICD-10-PCS (procedure) codes in compliance with official coding guidelines.
- DRG Grouping & Optimization: Evaluate principal diagnosis, secondary diagnoses, Complications/Comorbidities (CC), and Major Complications/Comorbidities (MCC) to ensure precise MS-DRG and APR-DRG sequencing.
- Physician Querying: Identify documentation gaps, ambiguities, or inconsistencies and initiate formal queries to Clinical Documentation Improvement (CDI) teams or physicians for clarification.
- Audit & Compliance: Participate in internal quality audits to maintain a minimum coding accuracy rate of 95%. Assist in analyzing coding-related claim denials and medical necessity rejections.
- Workflow Proficiency: Utilize encoding tools, electronic health record (EHR) systems, and computer-assisted coding (CAC) software efficiently.
Required Qualifications & Skills
- Education: Bachelor’s degree in Life Sciences, Nursing, Pharmacy, or Health Information Management (HIM).
- Experience: 2 to 4 years of dedicated inpatient DRG (IPDRG) coding experience in a hospital or RCM vendor environment.
Pay: ₹40,000.00 - ₹80,000.00 per month
Benefits:
- Leave encashment
- Provident Fund
Work Location: In person
