Job Description

The Inpatient Coding Specialist is responsible for the accurate and timely assignment of ICD-10-CM/PCS codes and DRGs for inpatient encounters in compliance with federal regulations, payer guidelines, and organizational policies. This role ensures data integrity, supports revenue cycle optimization, and maintains adherence to coding and documentation standards.

Education

• High School Diploma or Equivalent required

• Associate's Degree Medical Billing and Coding preferred

Experience

• 2+ years of medical coding experience required

Duties/Responsibilities:

• Review inpatient medical records (e.g., H&P, progress notes, operative reports, discharge summaries) to assign appropriate ICD-10-CM and ICD-10-PCS codes

• Accurately assign MS-DRG/APR-DRG based on clinical documentation and coding guidelines

• Ensure compliance with Official Coding Guidelines, AHA Coding Clinic, CMS regulations, and payer-specific requirements

• Identify documentation gaps and initiate physician queries in accordance with compliant query practices

• Validate and reconcile CAC (Computer Assisted Coding) suggestions, if applicable

• Meet or exceed productivity and quality benchmarks established by the organization

• Participate in internal and external coding audits; incorporate feedback into coding practice

• Collaborate with CDI, Quality, and Revenue Cycle teams to improve documentation and reimbursement outcomes

• Maintain confidentiality and compliance with HIPAA regulations

Knowledge, Skills and Abilities

• In-depth knowledge of medical coding systems, including ICD-10/PCS and their application in hospital billing.

• Strong understanding of coding guidelines, regulations, and industry best practices.

• Adhere to AHIMA standards of ethical coding and HIPAA regulations.

• Analyze full inpatient charts to ensure complete, compliant documentation.

• Determine the appropriate Diagnosis Related Group (DRG) to maximize appropriate reimbursement.

• Strong communication and interpersonal skills to effectively collaborate with healthcare providers, coders, and other stakeholders.

• Strong problem-solving skills to address coding-related challenges and implement effective solutions.

• Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment.

• Maintain established accuracy rates (typically 95% or higher) and daily coding quotas

Working Schedule:

• Remote, M-F eastern standard business hours. Requires a quiet, secure, HIPAA-compliant working station

Comprehensive benefits include PTO, retirement, tuition assistance, flexible hours. Paid CEUs/AHIMA Membership.

Mass General Brigham Incorporated is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.

Job Tags

Flexible hours

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