Executive - Coding Auditor

EXL; Chennai District; On-site; INR 400,000 - 600,000; Full time

Job summary

EXL in Chennai District is looking for an experienced Inpatient Medical Coder. Responsibilities include conducting thorough reviews of medical records, ensuring compliance with IPPS methodology, and mentoring coding staff. Candidates should hold a CCS certification and have a minimum of 2 years’ experience in IP DRG coding.

The role requires good excel skills and participation in quality audits and cross-functional meetings. Full-time working hours are 40 hours per week.

Qualifications

• Minimum 2 years’ experience in IP DRG coding or auditing.

Responsibilities

• Conduct comprehensive reviews of inpatient medical records.
• Ensure compliance with IPPS methodology and coding rules.
• Verify accuracy and specificity of diagnoses and procedures.
• Identify documentation gaps and collaborate for clarifications.
• Mentor and support coding staff.
• Perform routine coding quality audits.
• Analyze audit findings and prepare reports.
• Stay updated on regulatory changes.
• Participate in cross-functional meetings.

Skills

Auditing experience on IP DRG

Exposure to 3M software and NLP tool

Medical Coding

Coding Analyst

Good excel skills

Education

Bachelors in nursing preferable

Certification - CCS - Certified Coding Specialist

CIC - Certified Inpatient Coder

Job description

Conduct comprehensive reviews of inpatient medical records to validate that assigned ICD-10-CM/PCS codes and DRG classifications accurately reflect the documented clinical conditions and procedures.

Ensure compliance with IPPS (Inpatient Prospective Payment System) methodology, CMS guidelines, and official coding rules when determining DRG assignment.

Verify accuracy and specificity of diagnoses, procedures, POA indicators, and discharge disposition, ensuring documentation supports all coding decisions.

Identify documentation gaps and collaborate with clinical teams to obtain necessary clarifications for accurate code assignment.

Mentor, coach, and support coding staff, providing guidance on complex DRG and inpatient coding scenarios.

Deliver feedback and ongoing education to both coders and Clinical Documentation Improvement (CDI) specialists to improve coding quality and documentation completeness.

Perform routine coding quality audits to assess accuracy, identify trends, and recommend corrective actions.

Analyze audit findings and prepare detailed reports, highlighting errors, patterns, and opportunities for improvement.

Stay updated on regulatory changes, payer guidelines, and industry best practices related to IPPS, DRG validation, and inpatient coding.

Participate in cross-functional meetings with coding, CDI, compliance, and operations teams to strengthen documentation and coding accuracy across the organization.

Responsibilities

ADDITIONAL AND ESSENTIAL RESPONSIBILITIES:

• Follow every aspect of SOP without fail
• Complete received Audits with Quality
• To achieve Quality and production target
• Follow project related protocols and instructions
• Escalate issues, identify trends...
• Update all the logs like productivity, Clarification log, and any other logs applicable, daily
• Check with Manager /TL in case of clarifications
• All emails from Manager should be answered promptly without fail
• Ensure compliance of entire team for HIPAA,OIG
• Good excel skills

Qualifications

Qualifications: Bachelors in nursing preferable / bachelor’s in science.

Certification- Mandatory CCS - Certified Coding Specialist, CIC - Certified Inpatient Coder

Experience: Minimum 2 years’ experience in IP DRG coding or auditing.

Working Hours: 40 HOURS PER WEEK, FULL TIME EMPLOYEE

Skills and abilities:

• Auditing experience on IP DRG.
• Exposure on 3M software and NLP tool.

Required Skills

• Coding Analyst
• Medical Coding