• Conducting coding audits prior to payment release. • Performing post-payment coding reviews with overpayments. • Sending coding education correspondence to applicable providers. • Reviewing medical records, patient medical history and physical exams. • Assisting with validation audits to evaluate medical record documentation. • Interpreting medical documentation to ensure coding captures HCC conditions. • Developing tools and metrics to improve coding and documentation accuracy. • Providing high level of customer service to internal and external clients. • Escalating appropriate coding audit issues to management. • Participating in and supporting ad-hoc coding audits as needed. • Supporting ongoing programs to minimize organizational risk in RADV Audits. • Completing assigned coding projects. • Other duties as assigned.

• The Medical Coder 3 (inpatient and ambulatory surgery) abstracts clinical information from a variety of medical records, charts and documents and assigns appropriate ICD-10 - CM/PCS and CPT codes to patient records according to established procedures. • Works with coding databases and confirms DRG assignments. • Familiar with standard concepts, practices, and procedures within a particular field. • Relies on instructions and pre-established guidelines to perform the functions of the job. • This position relies on guidelines and some experience and judgment to complete job and works under general supervision.

• Analyzes relevant clinical and demographic information from the Health Information record • Assigns appropriate ICD-10 and CPT codes following appropriate guidelines • Ensures compliance with CMS, state and other regulatory agencies • Provides mentorship and training to on-boarding coders • Completes analysis of documentation, abstracting and code assignment by body system, organ, etiology and morphology • Performs queries and obtains documentation required for coding for records maintained in other departments • Coordinates documentation needs, query follow-up and final DRG assignment with the Clinical Documentation Specialist • Reviews provider documentation for coding appropriateness • Analyzes medical records to complete accurate code selection • Assigns diagnosis and procedure codes for clinic visits, surgical procedures/deliveries, and other billable professional services • Acts as a mentor to other team members

Role Description PQC is seeking qualified Inpatient Coder Specialists to support a high-impact project with the Defense Health Agency (DHA). In this role, you will be responsible for accurate medical coding and billing processes that directly support patient care operations within the Military Health System (MHS). This position requires a strong understanding of inpatient coding guidelines, attention to detail, and the ability to navigate healthcare systems. If you thrive in a fast-paced environment and are passionate about precision and compliance, this is an opportunity to contribute to a mission-driven healthcare system serving military members and their families. Key Responsibilities - Medical Coding & Classification: Accurately assign diagnosis and procedure codes for inpatient facility and professional services, including ICD-10-CM, ICD-10-PCS, E&M, CPT, and HCPCS codes, along with appropriate modifiers and units of service, based on medical record documentation. - Documentation Review & Query Resolution: Review patient encounter documentation to identify inconsistencies, ambiguities, or discrepancies; initiate and resolve coding queries with providers to ensure accurate and complete code assignment. - System Utilization & Data Access: Utilize MHS GENESIS® and other military health system platforms to access patient records, perform coding functions, and support remote coding efforts across multiple military treatment facilities (MTFs) as directed. - Coding Compliance & Regulatory Adherence: Ensure adherence to DHA coding compliance standards by applying ethical coding practices, interpreting official guidance, and seeking clarification through appropriate channels when needed. - Productivity & Quality Performance: Achieve and maintain established productivity benchmarks and a minimum 97% coding accuracy rate in alignment with organizational standards. - Provider Education & Support: Educate providers and clinical staff on documentation and coding requirements; provide feedback, answer questions, and offer examples to improve documentation quality and coding accuracy. - Collaboration & Subject Matter Expertise: Serve as a coding resource for medical staff; collaborate with auditors, trainers, and compliance personnel to support audits, training initiatives, and continuous improvement efforts. Qualifications - Minimum of four (4) years of experience coding and/or auditing in two (2) or more medical, surgical, and ancillary specialties within the past 10 years (required); OR - Minimum of two (2) years of experience if that experience was in support of a military treatment facility. - Experience coding and/or auditing same day surgery, emergency department, observation. Requirements - Education: Completion of ONE of the following: - Associate’s degree or higher in Health Information Management, Healthcare Administration, Biological Science, or a related field. - University certificate in medical coding. - Minimum of 30 semester hours of college coursework in relevant subjects (e.g., anatomy and physiology, medical terminology, health information management, pharmacology). - Successful completion of a coding certification preparation course (professional or facility) through American Academy of Professional Coders or American Health Information Management Association. - Completion of an advanced (post-apprentice) medical training program through the U.S. Armed Forces or U.S. Maritime Service (e.g., medical technician, hospital corpsman, or medical service specialist). - Certification: Must hold BOTH: - One (1) Professional Coding Certification (through AAPC or AHIMA), such as: - Certified Professional Coder (CPC) - Certified Coding Specialist – Physician (CCS-P) - Registered Health Information Administrator (RHIA) - Registered Health Information Technician (RHIT) - One (1) Institutional Coding Certification (through AAPC or AHIMA), such as: - Certified Inpatient Coder (CIC) - Certified Coding Specialist (CCS) - Certified Outpatient Coder (COC) - Registered Health Information Administrator (RHIA)* - Registered Health Information Technician (RHIT)* - Note: RHIA and RHIT credentials may be applied toward either the professional or institutional certification requirement. Company Description PQC is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.