Job Description

• Maintains a working knowledge of CPT-4, ICD-10-CM and ICD-10-PCS coding principles, governmental regulations, UHDDS (Uniform Hospital Discharge Data Set) guidelines, AHA coding clinic updates and third-party requirements regarding Coding and documentation guidelines

• Knowledge of Physician query process and ability to write physician query in compliance with OIG and UHDDS regulations

• Knowledge of MS-DRG (Medicare Severity Diagnosis Related Groups), MDC (Major Diagnostic Categories), AP-DRG (All Patient DRGs), APR-DRG (All Patient Refined DRGs) with hands-on experience in handling MS-DRG

• Knowledge of CC (complication or comorbidity) and MCC (major complication or comorbidity) when used as a secondary diagnosis

• Understanding and exposure to Clinical Documentation Improvement (CDI) program to work in tandem with MS-DRG

• Hands-on experience in any of the Encoder tools specific to Hospital coding such as 3M, Trucode, etc. is preferred

• The coders assigned on the project would be reviewing Inpatient and observation medical records, determine and assign accurate diagnosis (ICD-10-CM) codes and Procedure codes (ICD-10-PCS and/or CPT) codes with appropriate modifiers in addition to reporting any deviations in a timely manner

• Maintains high level of productivity and quality

• Achieve the set targets and cooperate with the respective team in achieving the set Turnaround Time keeping an elevated level of accuracy

• The coders would as well be screened for reasonable comprehension and analytical skills that are considered a prerequisite for reviewing the medical documentation and deliver accurate coding

• The coders are expected to deliver an internal accuracy of 95%, meet turnaround time requirements in addition to meeting productivity standards set internally per the specialty

• Maintains high degree of professional and ethical standards

• Focuses on continuous improvement by working on projects that enables customers to arrest revenue leakage while being in compliance with the standards.

• Focuses on updating coding skills and knowledge by participating in coding team meetings and educational conferences. This includes refresher and ongoing training programs conducted periodically within the organization

Job REQUIREMENTs

To be considered for this position, applicants need to meet the following qualification criteria:

• Graduates in life sciences with 1 - 4 years’ experience in Medical Coding

• Candidates holding CCS/CIC with hospital coding experience are preferable

• The coders will focus on undergo certifications sponsored by AAPC and AHIMA as they mature with the process.  Access health care has now partnered with AAPC to hand hold in-house certification training for its coders and sponsor for the examinations.

• Good knowledge of medical coding and billing systems, medical terminologies, regulatory requirements, auditing concepts, and principles

GROW YOUR CAREER WITH Pacific BPO, an access healthcare company