IP Medical Coder

• The incumbent checks and sequences the most accurate ICD-9-CM/CPT/HCPCS/DRG/Other codes for diagnoses and procedures for documented information. Assures the final diagnoses and operative procedures as stated by the physician are valid and complete. • Prepare daily& monthly coding audit reports. • Abstracts all necessary information from health records to identify secondary complications and co-morbid conditions. • Evaluates the record for documentation consistency and adequacy. Ensures that the final diagnosis accurately reflects the care and treatment rendered. • Ensures coding is as per DOH guidelines and regulations. • Provides feedback to Doctors regarding coding errors or oversights. • Constantly updates to the latest coding versions and DOH coding directives. • Maintain inter and interdepartmental communication for the smooth functioning of the department. • Strictly adheres to organization’s regulations and policies especially those related to infection control, patient safety, OSHMS, DOH, JCI and ISO. • Supports Continuous Quality Improvement and participates and contributes to all the quality assurance activities of the service. • Participates and contributes in scheduled in-service training programs, In house activities, conferences or other programs as requested. • Maintains confidentiality as per the agreement signed. • Demonstrates the ability to listen to others in promoting effective communication. • Develops thorough understanding of policies and procedures of the hospital and demonstrates respect for them. • Carries out other duties when requested by the Head of department. • Reviews and sequences accurate ICD-9-CM, CPT, HCPCS, DRG , and other applicable codes for diagnoses and procedures based on documented clinical information. • Ensures final diagnoses and operative procedures documented by physicians are valid, complete, and compliant . • Prepares daily and monthly coding audit reports . • Abstracts required information from health records to identify secondary complications and co-morbid conditions . • Evaluates medical records for documentation consistency, adequacy, and accuracy , ensuring diagnoses reflect the care and treatment provided. • Ensures coding compliance with DOH guidelines and regulatory requirements . • Provides constructive feedback to physicians regarding coding errors or documentation gaps. • Stays updated with the latest coding standards, revisions, and DOH directives . • Maintains effective intra- and inter-departmental communication to support smooth departmental operations. • Adheres strictly to organizational policies, including infection control, patient safety, OSHMS, DOH, JCI, and ISO standards . • Supports Continuous Quality Improvement (CQI) initiatives and actively participates in quality assurance activities. • Participates in in-service training programs, in-house activities, conferences , and other assigned programs. • Maintains patient and organizational confidentiality as per signed agreements. • Demonstrates effective listening and communication skills to promote collaboration. • Develops a thorough understanding of hospital policies and procedures and demonstrates compliance. • Performs additional duties as assigned by the Head of Department. • Graduate in Allied Health Sciences or a related field • Certified Coding Associate (CCA) certification from the American Health Information Management Association (AHIMA) Experience • Minimum of two (2) years of professional coding experience Skills • Strong computer literacy • Excellent oral and written communication skills in English