Medical Coder - Taguig, National Capital Region

Para lamang sa mga rehistradong miyembro Taguig, National Capital Region, Pilipinas

1 buwan ang nakalipas

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Job summary

The Medical Coder-Inpatient DRG (IPDRG) provides high-level technical competency and subject matter expertise in analyzing physician/provider documentation in Inpatient health records to determine the principal diagnosis, secondary diagnoses, principal procedure, and secondary procedures. Assigns appropriate Medicare Severity Diagnosis Related Groups (MS-DRG), All Patient Refined DRGs (APR), Present on Admission (POA), as well as Severity of Illness (SOI) & Risk of Mortality (ROM) indicators for Inpatient records.

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Responsibilities

  • Assign appropriate code(s) by utilizing coding guidelines established by: The Centers for Disease Control (CDC), ICD-CM Official Coding Guidelines for Coding and Reporting, Centers for Medicare/Medicaid Services (CMS) ICD-PCS Official Guidelines for Coding and Reporting American Hospital Association (AHA) Coding Clinic for International Classification of Diseases, Clinical Modification American Health Information Management Association (AHIMA) Standards of Ethical Coding Revenue Excellence/HM coding procedures and guidelines Navigate the patient health record and other computer systems/sources to accurately determine diagnosis and procedures codes MS-DRGs APR DRGs POA SOI ROM indicators that could impact quality data hospital reimbursement Code Inpatient health records utilizing encoder software consistently uses online tools to support the coding process references assign ICD codes MS-DRG APR DRG assignments Review Inpatient health record documentation assess the presence clinical evidence/indicators support diagnosis code MS-DRG APR DRG assignments decrease denials Work on inpatient claim edits may code consecutive/combined accounts comply with 72-hour rule account combine scenarios Adhere to the Inpatient coding quality productivity standards established organization Safeguard patient health information compliance HIPAA standards Query Management Follow-Up Demonstrate knowledge current compliant coder query practices consulting physicians Clinical Documentation Specialists CDS healthcare providers additional information needed coding clarify conflicting ambiguous documentation Utilize EMR communication tools track missing documentation queries require follow-up facilitate timely fashion HIM Collaboration Work with HIM Patient Financial Services PFS teams help resolve billing claims denial appeals issues affecting reimbursement+
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