- 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 queries 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 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, determining accurate diagnosis (ICD-10-CM) codes and Procedure codes (ICD-10-Pand/or CPT) codes with appropriate modifiers in addition to reporting any deviations .promptly
- Maintains a 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
- We will screen for reasonable comprehension and analytical skills, which are considered a prerequisite for reviewing the medical documentation and delivering accurate Coding.
- The coders must deliver an internal accuracy of 95%, meet the turnaround time requirements, meeting the productivity standards set internally per the specialty.
- Maintains a high degree of professional and ethical standards
- Focuses on continuous improvement by working on projects that enable customers to arrest revenue leakage while complying with the standards.
- Focuses on updating coding skills and knowledge by participating in coding team meetings and educational conferences
- Conduct refresher and ongoing training programs conducted periodically within the organization
- 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 undergoing certifications sponsored by AAPC and AHIMA as they mature with the process. Access health care has now partnered with AAPC to handhold in-house certification training for coders and sponsor examinations.
- Good knowledge of medical Coding and billing systems, medical terminologies, regulatory requirements, auditing concepts, and principles
Client Partner - Pune, India - Access Healthcare Services
Description
Job Description
JOB REQUIREMENTS
To be considered for this position, applicants need to meet the following qualification criteria:
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