Remote Inpatient Coder

Summary

Our award-winning client is seeking a skilled and experienced Inpatient Coder to join their health information management team. The primary goal of this position is to ensure the integrity and accuracy of inpatient medical record coding and subsequent billing claims. As an Inpatient Coder, you will perform comprehensive chart reviews to assign accurate ICD-10-CM / PCS codes, ensure compliance with official coding guidelines, and ultimately secure appropriate reimbursement through precise DRG assignment. This role requires expert knowledge in complex coding principles, clinical documentation requirements, and regulatory standards.

Responsibilities

• Accurate Code Assignment : Conduct comprehensive analysis and review of complex inpatient medical records to accurately assign the principal diagnosis, secondary diagnoses, and all procedures utilizing ICD-10-CM and ICD-10-PCS classification systems.
• DRG Validation & Compliance : Ensure strict adherence to the Official Coding and Reporting Guidelines to validate that the assigned codes result in the most accurate and appropriate MS-DRG and / or APR-DRG for billing purposes.
• Medical Record Review : Perform detailed and timely reviews of clinical documentation to confirm that it fully supports all coded diagnoses and procedures. Identify and query physicians for clarification on incomplete, inconsistent, or ambiguous documentation.
• Error Prevention & Quality Improvement : Minimize coding errors through diligent review and application of coding rules. Identify documentation trends and suggest process improvements to enhance overall clinical documentation quality and coder efficiency.
• Collaboration : Effectively consult and collaborate with clinical documentation specialists (CDS), physicians, and other care team members to ensure documentation integrity and resolve complex coding scenarios.
• Workflow Management : Manage, prioritize, and organize a full inpatient coding workload, demonstrating the ability to independently meet high productivity and quality standards.
• Professional Development : Attend all mandatory departmental team meetings, training sessions, and remain current on changes to coding guidelines, regulatory mandates, and hospital policies.
• Other Duties : Complete additional tasks or special projects as assigned by leadership.

Required Qualifications

Preferred Skills