Coder III

Assign diagnosis, procedure, and DRG codes to ensure quality documentation and accurate reimbursement for services provided.

Reviews complex documentation from medical records to identify appropriate diagnostic and procedural codes (ICD, PCS, CPT).

Uses coding guidelines, LCDs, NCDs, and other resources to accurately assign and sequence codes and assign DRGs. Identifies quality concerns and refers them to the quality department as indicated.

Reviews CDI documentation and collaborates closely with CDI staff to ensure accurate DRG/AAPC assignment and justify discrepancies.

Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding and optimize DRG and severity of illness documentation.