Discover your 100% YOU with MicroSourcing!Position: Medical Coder - Inpatient DRG (IPDRG)
Location: Picadilly Star Building, BGC
Work setup & shift: Day Shift & Onsite
Why join MicroSourcing Youu0027ll have:- Competitive Rewards: Enjoy above-market compensation, healthcare coverage on day one, plus one or more dependents, paid time-off with cash conversion, group life insurance, and performance bonuses
- A Collaborative Spirit: Contribute to a positive and engaging work environment by participating in company-sponsored events and activities.
- Work-Life Harmony: Enjoy the balance between work and life that suits you with flexible work arrangements.
- Career Growth: Take advantage of opportunities for continuous learning and career advancement.
- Inclusive Teamwork: Be part of a team that celebrates diversity and fosters an inclusive culture.
Your Role:
The Medical Coder-Inpatient DRG (IPDRG) provides high level technical competency and subject matter expertise 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. Identifies Hospital Acquired Conditions (HAC), Patient Safety Indicators (PSI) to ensure accurate hospital reimbursement.
As a an IP DRG Medical Coder, you will:
Documentation Review and Code Assignment- Assigns 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
- Navigates the patient health record and other computer systems/sources to accurately determine diagnosis and procedures codes, MS-DRGs, APR DRGs, and identify HACs and PSIs or other indicators that could impact quality data and hospital reimbursement.
- Codes Inpatient health records utilizing encoder software and consistently uses online tools to support the coding process and references to assign ICD codes, MS-DRG, APR DRGs, POA, SOI & ROM indicators.
- Reviews Inpatient health record documentation, as part of the coding process, to assess the presence of clinical evidence/indicators to support diagnosis code and MS-DRG, APR DRG assignments to potentially decrease denials.
- Works Inpatient claim edits and may code consecutive/combined accounts to comply with the 72-hour rule and other account combine scenarios.
- Adheres to the Inpatient coding quality and productivity standards established by the organization.
- Safeguard patient health information in compliance with HIPAA standards.
Query Management & Follow-Up- Demonstrates knowledge of current, compliant coder query practices when consulting with physicians, Clinical Documentation Specialists (CDS) or other healthcare providers when additional information is needed for coding and/or to clarify conflicting or ambiguous documentation.
- Utilizes EMR communication tools to track missing documentation or Inpatient queries that require follow-up to facilitate coding in a timely fashion.
HIM Collaboration- Works with HIM and Patient Financial Services (PFS) teams, when needed, to help resolve billing, claims, denial and appeals issues affecting reimbursement.
Coding Knowledge & Expertise- Maintains CEUs as appropriate for coding credentials as required by credentialing associations.
- Maintains current knowledge of changes in Inpatient coding and reimbursement guidelines and regulations as well as new applications or settings for Inpatient coding e.g., Hospital at Home.
- Identifies and reports coding and/or EMR workflow issues to their supervisor.
- Exhibits awareness of health record documentation or other coding ethics concerns. Notifies appropriate leadership for assistance, resolution when appropriate.
- Maintains a working knowledge of applicable coding and reimbursement Federal, State and local laws and regulations, Code of Ethics, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior.
- Performs abstracting of additional data elements.
Other duties and responsibilities as assigned. What You Need: Non-Negotiables:- Coding Experience: At least 2 years inpatient DRG Coding experience.
- Education: Bachelor of Science in allied health field.
- Credential/Certification: Active Certified Coding Specialist (CCS) or Certified Inpatient Coder (CIC) or Certified Documentation Improvement Practitioner (CDIP)
- RCM Knowledge: Extensive, comprehensive working knowledge of medical terminology, Anatomy and Physiology, diagnostic and procedural coding and MS-DRG, APR DRG assignment. Must be proficient in identifying POA, SOI and ROM indicators for Inpatient records as well as HACs and PSIs to ensure accurate hospital reimbursement. Familiarity with HIPAA regulations.
- Software Knowledge: Proficiency with electronic medical records (EMR) such as Epic, Cerner, or Meditech.
- Excellent verbal and written English communication skills and customer service skills (CEFR level of at least B2 for both verbal and written)
Preferred Qualifications:- Education: Masteru0027s degree or credential in business, healthcare, or related field preferred
- Licensure: Registered Nurse and with active PHRN or USRN license preferred.
- Software Knowledge: Current experience utilizing encoding/grouping software and Computer Assisted Coding (CAC) is preferred. Encoder experience (3M/Solventum, Encoder Pro, Codify) preferred. Proficiency with Microsoft office suite (Excel, Word, PowerPoint, Outlook, SharePoint) . Proficiency with Microsoft office suite (Excel, Word, PowerPoint, Outlook, SharePoint)
- RCM Knowledge: Prior experience with US healthcare providers or payers.
Soft Skills:- Ability to pay close attention to details strong follow-up and follow-through skills
- Regularly makes complex decisions within the scope of the position, and is comfortable working independently
- Requires the use of independent judgment, discretion and decision-making abilities
- Demonstrates teamwork and integrity in all work-related activities
- Ability to interact with internal and external customers in a professional manner
- Strong analytical and critical thinking skills.
- Experience in a matrixed environment
- Excellent English written and verbal communication skills
- Knows, understands, incorporates, and demonstrates Huronu0027s Vision, and Values in behaviors, practices, and decisions.
IP DRG Coding Key Performance Indicators (KPIs) - Expectations- Coding Productivity: 95%
- DRG Accuracy Rate 95%
- Coding Accuracy: 95%
- Query Compliance: 100% adherence to AHIMA/ACDIS standards
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About MicroSourcing With over 9,000 professionals across 13 delivery centers, MicroSourcing is the pioneer and largest offshore provider of managed services in the Philippines.
Our commitment to 100% YOU MicroSourcing firmly believes that our companyu0027s strength lies in our peopleu0027s diversity and talent. We are proud to foster an inclusive culture that embraces individuals of all races, genders, ethnicities, abilities, and backgrounds. We provide space for everyone, embracing different perspectives, and making room for opportunities for each individual to thrive.
At MicroSourcing, equality is not merely a slogan - itu0027s our commitment. Our way of life. Here, we donu0027t just accept your unique authentic self - we celebrate it, valuing every individualu0027s contribution to our collective success and growth. Join us in celebrating YOU and your 100%!
For more information, visit https://www.microsourcing.com/
.Terms & conditions apply
About the Client - Huron
Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes.
Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and
communities to build cultures that foster innovation to achieve the best outcomes for patients.
Joining the Huron team means you'll help our clients evolve and adapt to the rapidly changing healthcare environment and optimize existing business operations, improve clinical outcomes, create a more consumer-centric healthcare experience, and drive physician, patient and employee engagement across the enterprise.
