Job Title: Inpatient Coder - MS-DRG/APR-DG - Remote
Responsibilities: - Follow national coding standards and regulatory guidance, including ICD-9, ICD-10-CM/PCS, AHA Coding Clinic, CMS, and other applicable compliance requirements.
- Apply UHDDS criteria and relevant regulations to determine and sequence principal and secondary diagnoses and procedures, ensuring appropriate DRG assignment (MS-DRG/APR-DRG).
- Assign Present on Admission (POA) indicators accurately for all inpatient diagnoses.
- Identify and document hospital-acquired conditions (HACs) based on provider documentation and ensure proper reporting to quality teams.
- Review patient records for accuracy, including discharge status and supporting documentation, to maintain coding integrity.
- Develop and submit compliant provider queries when documentation is unclear, incomplete, or conflicting, following industry standards for query practices.
- Extract key clinical information from medical records and input data into coding and abstracting systems.
- Monitor and resolve pre-bill edits, correcting coding discrepancies and completing any missing information prior to billing.
- Work collaboratively with Health Information Management (HIM) teams and Clinical Documentation Improvement (CDI) staff to support accurate and thorough documentation.
- Utilize coding platforms and health information systems efficiently to ensure timely and accurate code assignment and billing in line with DNFB targets and organizational policies.
- Participate in ongoing professional development activities, such as trainings and webinars, to maintain coding knowledge and required continuing education credits.
Required Skills: - Minimum of five years of hands-on experience utilizing ICD-10-CM/PCS classification systems, along with familiarity with MS-DRG and APR-DRG reimbursement methodologies.
- Completion of an accredited AHIMA training program is preferred, along with a relevant certification such as RHIA, RHIT, CCS, or similar credentials
- Proven experience coding within an acute care setting, including Level 1 trauma and teaching facilities, as well as transplant cases (kidney, liver, pancreas)
Preferred Skills: - An associate degree or higher in Health Information Management or a related field is strongly preferred
- Experience in a large-scale hospital environment (500+ beds) with exposure to diverse service lines; familiarity with facility-specific coding practices and electronic medical record systems such as Epic and 3M 360 is advantageous
- Broad coding background across multiple specialties, including general medical/surgical, orthopedics, cardiothoracic, vascular, bariatric, gynecology, neurology, urology, colorectal, behavioral health, gastroenterology, and wound care
- Ability to consistently meet established benchmarks for coding accuracy and productivity
- Willingness to complete and pass a coding skills assessment as part of the hiring process
Schedule/Shift: Flexible- 7AM-7PM EST
Location: Remote
Pay: 60,000
* We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).
* As a job position within our Revenue Cycle division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, handling financial and other payment data, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.