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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 compliance with IPPS methodology, CMS guidelines, and official coding rules. Proven ability to mentor coding staff, conduct audits, and analyze findings while ensuring adherence to HIPAA and OIG requirements.
Highest-signal resume keywords
ICD-10-CM/PCS CodingCertified Coding Specialist (CCS)Inpatient DRG CodingAuditing ExperienceCompliance Knowledge
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/PCS CodingInpatient DRG CodingAuditingCoding Quality AuditsDocumentation Gap AnalysisReport PreparationSOP ComplianceQuality Target AchievementProductivity LoggingRegulatory Monitoring
Soft Skills
MentoringCoachingCommunicationCollaborationFlexibility
Tools & Technologies
Microsoft OutlookMicrosoft ExcelMicrosoft Word3M SoftwareNLP Tools
Certifications & Qualifications
Certified Coding Specialist (CCS)Certified Inpatient Coder (CIC)
Industry Keywords
IPPS MethodologyCMS GuidelinesHIPAA ComplianceOIG ComplianceClinical 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 clarifications
- Mentor, coach, and support coding staff
- Deliver feedback and education to coders and CDI specialists
- Perform routine coding quality audits
- Analyze audit findings and prepare detailed reports
- Monitor regulatory changes, payer guidelines, and industry best practices
- Participate in cross-functional meetings with coding, CDI, compliance, and operations teams
- Follow SOPs and project protocols
- Complete audits with quality and achieve quality and production targets
- Escalate issues and identify trends
- Update productivity and clarification logs daily
- Coordinate with managers or team leads on clarifications
- Respond promptly to manager emails
- Ensure team compliance with HIPAA and OIG requirements
Requirements
What you’ll need- Bachelor's degree in nursing preferred or bachelor's degree 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
- Compliance knowledge related to HIPAA and OIG
Benefits
Comp & perks- Full-time employment
- Hybrid work arrangement
- 40 hours per week