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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in ICD-10-CM/PCS coding and DRG classifications, ensuring compliance with CMS guidelines and conducting thorough audits. Capable of mentoring coding staff and collaborating with clinical teams to enhance documentation accuracy and coding quality.
Highest-signal resume keywords
ICD-10-CM/PCS CodingCertified Coding Specialist (CCS)IP DRG Coding Experience3M Software ExposureAuditing Experience
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
ICD-10-CM CodingICD-10-PCS CodingDRG ClassificationCoding Quality AuditsDocumentation Gap AnalysisRegulatory ComplianceAudit ReportingCoding Guidelines KnowledgeSOP AdherenceProduction Target Achievement
Soft Skills
Good CommunicationMentoringCollaborationFlexibility
Tools & Technologies
Microsoft OutlookMicrosoft ExcelMicrosoft Word3M SoftwareNLP Tools
Certifications & Qualifications
Certified Coding Specialist (CCS)Certified Inpatient Coder (CIC)
Industry Keywords
IPPS MethodologyCMS GuidelinesHIPAA ComplianceOIG RequirementsClinical Documentation Improvement (CDI)
About the role
Key responsibilities & impact- Conduct comprehensive reviews of inpatient medical records to validate ICD-10-CM/PCS codes and DRG classifications
- Ensure compliance with IPPS methodology, CMS guidelines, and official coding rules
- Verify diagnoses, procedures, POA indicators, and discharge disposition
- Identify documentation gaps and collaborate with clinical teams for clarification
- Mentor, coach, and support coding staff
- Provide feedback and education to coders and CDI specialists
- Perform routine coding quality audits
- Analyze audit findings and prepare detailed reports
- Stay updated on regulatory changes, payer guidelines, and industry best practices
- Participate in cross-functional meetings with coding, CDI, compliance, and operations teams
- Follow SOPs, project protocols, and instructions
- Complete audits with quality and meet quality and production targets
- Escalate issues and identify trends
- Update productivity, clarification, and other applicable logs daily
- Coordinate with managers or team leads on clarifications
- Ensure team compliance with HIPAA and OIG requirements
Requirements
What you’ll need- Bachelor’s in nursing preferable / bachelor’s in science
- Mandatory CCS (Certified Coding Specialist) or CIC (Certified Inpatient Coder) certification
- Minimum 2 years’ experience in IP DRG coding or auditing
- Auditing experience on IP DRG
- Knowledge of Microsoft Outlook, Excel, and Word
- Exposure to 3M software and NLP tools
- Good Excel skills
- Flexibility
- Good communication
- Ability to work 40 hours per week
Benefits
Comp & perks- Full-time employment
- Hybrid work arrangement