In patient Coder

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.