IP Medical Coder

Job Summary: The Inpatient Medical Coder is responsible for reviewing and accurately assigning medical codes for inpatient services based on documentation, ensuring compliance with ICD-10-CM, ICD-10-PCS, CPT, HCPCS, and payer guidelines. This role plays a critical part in the revenue cycle process by optimizing reimbursement and minimizing claim denials. The ideal candidate should have strong attention to detail, a deep understanding of medical terminology, and expertise in coding regulations.

Key Responsibilities:

• Review and analyze inpatient medical records.
• Ensure coding compliance with AAPC, AHIMA, CMS, and payer-specific guidelines.
• Abstract and validate clinical information to support accurate coding and billing.
• Identify and resolve coding discrepancies, providing clarification when needed.
• Collaborate with physicians, clinical staff, and billing teams to ensure accurate documentation.
• Assist in denials management, reviewing claim rejections, and submitting appeals when necessary.
• Maintain confidentiality and ensure compliance with HIPAA regulations.
• Stay updated with coding changes, regulatory updates, and industry best practices.
• Participate in internal coding audits and quality assurance to maintain high accuracy levels.

Qualifications & Skills:

• Active medical coding certification (e.g., CCS, CPC, CIC, RHIT, RHIA) from AAPC or AHIMA.
• 3-5 years of inpatient coding experience in a hospital or healthcare BPO setting.
• Strong knowledge of ICD-10-CM, ICD-10-PCS, DRG, CPT, HCPCS, and medical necessity guidelines.
• Experience with Electronic Health Records (EHR), hospital billing systems, and coding software.
• Familiarity with payer guidelines, reimbursement methodologies, and appeals processes.
• Strong analytical skills with attention to detail and accuracy.
• Ability to work independently in a fast-paced, high-volume environment.
• Excellent written and verbal communication skills.