IP-DRG - Coders & QA

Key Responsibilities:

IP-DRG Coder

• Review inpatient clinical documentation and assign accurate ICD-10-CM/PCS codes.
• Assign appropriate MS-DRGs/APR-DRGs based on documented diagnoses and procedures.
• Ensure 100% adherence to coding guidelines, payer-specific rules, and DRG logic.
• Collaborate with documentation teams to resolve ambiguities and initiate physician queries if needed.
• Meet daily productivity and accuracy benchmarks (95%+ accuracy).

IP-DRG QA (Quality Analyst)

• Audit inpatient coded charts for accuracy and DRG compliance.
• Provide detailed feedback and corrective training to coders based on audit findings.
• Monitor coding trends and ensure alignment with CMS, AHA, and UHDDS guidelines.
• Maintain audit dashboards, quality logs, and client reports.
• Participate in coder upskilling, calibration sessions, and process improvement.

Qualifications:

• Education: Graduate in Life Sciences / Paramedical / Nursing or equivalent
• Certification (Mandatory):
• AAPC or AHIMA Certified CIC, CCS, or CPC-H/COC
• Experience:
• Coders: Minimum 2 years in inpatient hospital coding
• QA: 35 years of inpatient coding + auditing experience