Inpatient Medical Coder | IP DRG Coder | Coding Quality Analyst

Inpatient Medical Coder / Quality Analyst – IP DRG

Responsible for performing inpatient coding quality audits, DRG validation, clinical documentation reviews, and complex case assessments to ensure coding accuracy, compliance, and appropriate reimbursement. Utilizes inpatient coding guidelines, clinical documentation, and professional resources to identify discrepancies and validate billed diagnoses and DRG assignments.

Key Responsibilities

• Perform comprehensive quality audits of inpatient medical records to validate diagnoses, procedures, ICD-10-CM/PCS codes, and DRG assignments.
• Review clinical documentation to determine whether reported diagnoses and DRGs are fully supported by the medical record and applicable coding guidelines.
• Identify coding discrepancies, documentation issues, and potential DRG inaccuracies, and document audit findings clearly and accurately.

Qualifications

• Minimum of 1 to 3 years of inpatient medical coding experience.
• Active PHRN License
• Proven experience with inpatient coding and Diagnosis-Related Group (DRG) coding.
• Experience in coding quality assurance, auditing, clinical validation, or documentation review preferred.
• Strong knowledge of ICD-10-CM, ICD-10-PCS, MS-DRG, and inpatient coding guidelines.

Preferred Certifications

• CCS – Certified Coding Specialist
• CIC – Certified Inpatient Coder
• CCDS – Certified Clinical Documentation Specialist
• CDIP – Certified Documentation Improvement Practitioner