APDRG Coder
Talentgigs
About the Role
We are looking for an experienced APDRG Coder to review inpatient medical records, analyze clinical documentation, and accurately assign appropriate diagnosis-related group (DRG) classifications. This role requires strong knowledge of inpatient coding, medical terminology, clinical documentation, and DRG assignment methodologies.
Key Responsibilities
- Review inpatient medical records, discharge summaries, physician notes, and other clinical documentation.
- Analyze principal diagnoses, secondary diagnoses, comorbidities, complications, and relevant procedures to support accurate DRG assignment.
- Assign appropriate ICD-10-CM and ICD-10-PCS codes, as applicable.
- Apply relevant APDRG classification rules and guidelines to determine the appropriate DRG.
- Identify documentation gaps, inconsistencies, and potential coding errors, and seek clarification.
- Ensure coding accuracy, compliance, and adherence to applicable coding standards and organizational policies.
- Review clinical documentation to identify factors that may affect DRG assignment, severity, and reimbursement.
- Meet established productivity, quality, and turnaround-time targets.
- Collaborate with coding auditors, clinical documentation teams, and other healthcare RCM stakeholders to resolve coding-related queries.
- Stay updated on changes to coding guidelines, DRG classification systems, and payer-specific requirements.
Requirements & Tech Stack
- Hands-on experience in inpatient medical coding and DRG classification.
- Strong understanding of APDRG methodology and applicable DRG grouping guidelines.
- Good knowledge of medical terminology, anatomy, physiology, and disease processes.
- Proficiency in interpreting inpatient medical records and discharge summaries.
- Understanding of ICD-10-CM and ICD-10-PCS coding.
- Strong analytical skills and attention to detail.
- Ability to meet quality and productivity targets in a deadline-driven environment.
- Good communication and documentation skills.
Qualifications
- Relevant medical coding certification, such as CCS or an equivalent credential.
- Experience with inpatient coding audits and DRG validation.
- Exposure to clinical documentation improvement (CDI) and coding compliance processes.

