Inpatient (IP) Medical Coder
Nextsphere Strategic Management Services Taguig Full-time
Job Summary
We are hiring a detail-oriented Inpatient Medical Coder with strong expertise in hospital-based coding, DRG assignment, and US healthcare compliance.
This role is responsible for accurately reviewing inpatient medical records and assigning appropriate diagnosis and procedure codes to ensure proper reimbursement and compliance with regulatory standards.- Key Responsibilities
- Review inpatient medical records and assign accurate ICD-10-CM and ICD-10-PCS codes
- Perform MS-DRG and APR-DRG assignment
Ensure correct identification of:
- POA (Present on Admission)
- SOI (Severity of Illness)
- ROM (Risk of Mortality)
- HACs (Hospital-Acquired Conditions)
- PSIs (Patient Safety Indicators)
- Maintain compliance with HIPAA and US healthcare regulations
- Work with clinical documentation to ensure coding accuracy
- Meet productivity and quality benchmarks
- Utilise EMR and encoding tools efficiently
Required Qualifications
Coding Experience- Minimum 2 years of inpatient medical coding experience
- Strong background in hospital inpatient coding workflows
- Bachelor's degree in an allied health field
Certification
Must have at least one active certification:
- CCS (Certified Coding Specialist)
- CIC (Certified Inpatient Coder)
- CDIP (Certified Documentation Improvement Practitioner)
- Candidates must hold at least one of the following certifications: CCS, CIC, or CDIP, with any single certification being sufficient for this role
(License number required for verification)
Technical Knowledge
Strong understanding of:
- ICD-10-CM (Diagnosis Coding)
- ICD-10-PCS (Procedure Coding)
- MS-DRG (Medicare Severity Diagnosis Related Groups)
- APR-DRG (All Patient Refined DRG)
Knowledge of:
- POA indicators
- SOI and ROM classification
- HACs and PSIs
- HIPAA compliance standards
Systems & Tools
Experience with EMR systems such as:
- Epic
- Cerner
- Meditech
- Experience with any EMR system is acceptable, not limited to the systems listed above
- Strong English communication skills (verbal and written)
- Minimum CEFR Level B2
- Good documentation and collaboration skills
- Master's degree in healthcare, business, or related field
- Active RN license (PHRN or USRN)
Experience with:
- Encoder tools (3M/Solventum, Encoder Pro, Codify)
- Computer-Assisted Coding (CAC) systems
- Microsoft Office (Excel, Word, PowerPoint, Outlook, SharePoint)
- Experience working with US healthcare providers or payers
- Meet defined coding productivity standards (charts per day)
- Maintain high coding accuracy and quality scores
- Ensure compliance with regulatory and client standards
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