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Discover your 100% YOU with MicroSourcing !
Position: Medical Coder - Inpatient DRG (IPDRG) Location: BGC, Taguig City Work setup & shift: WFH, Day shift ( *Terms and conditions apply.) Salary: Up to 100K!
SOB: Equivalent to 1 month's salary + 50K! *Terms and conditions apply.
Why join MicroSourcing ?
You'll 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 in 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) and Patient Safety Indicators (PSI) to ensure accurate hospital reimbursement.
As a Medical Coder - Inpatient , you will:
Documentation Review and Code Assignment
Assign 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
Navigate 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.
Code 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.
Review 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.
Work on inpatient claim edits and may code consecutive/combined accounts to comply with the 72-hour rule and other account combine scenarios.
Adhere 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
Demonstrate 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.
Utilize EMR communication tools to track missing documentation or Inpatient queries that require follow-up to facilitate coding in a timely fashion.
HIM Collaboration
Work with HIM and Patient Financial Services (PFS) teams, when needed, to help resolve billing, claims, denial, and appeals issues affecting reimbursement.
Coding Knowledge & Expertise
Maintain CEUs as appropriate for coding credentials as required by credentialing associations.
Maintain 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.
Identify and report coding and/or EMR workflow issues to their supervisor.
Exhibit awareness of health record documentation or other coding ethics concerns. Notifies appropriate leadership for assistance and resolution when appropriate.
Maintain 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.
Perform abstracting of additional data elements.
Other duties and responsibilities as assigned.
What You Need
Non-negotiables
Coding Experience: At least 2 years of Inpatient DRG Coding experience.
Education: Bachelor of Science in allied health field.
Credential/Certification: ActiveCertified 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 skills/expertise
Education: Master's degree or credential in business, healthcare, or related field preferred
Licensure: Registered Nurse with an 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
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 company's strength lies in our people's 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 - it's our commitment and our way of life. Here, we don't just accept your unique, authentic self—we celebrate it, valuing every individual's contribution to our collective success and growth. Join us in celebrating YOU and your 100%!