Executives-Auditors-DRG

EXL Talent Acquisition Team; Chennai; Presencial; INR 600.000 - 1.200.000; Jornada completa

Descripción de la vacante

EXL Talent Acquisition Team seeks an experienced inpatient coder to conduct comprehensive reviews of medical records, validate ICD-10-CM/PCS codes, and ensure DRG classifications reflect documented conditions. The role ensures IPPS compliance with CMS guidelines, verifies diagnoses, POA indicators and discharge dispositions, and identifies documentation gaps while collaborating with clinical teams.

You will mentor coders and CDI specialists, deliver ongoing education, perform quality audits, and

Formación

• Proven inpatient coding and DRG classification experience.
• Strong ICD-10-CM/PCS knowledge and CMS rules.
• IPPS/CMS familiarity is a plus.
• Ability to mentor coding staff and provide education.

Responsabilidades

• Conduct comprehensive reviews of inpatient medical records to validate ICD-10-CM/PCS codes and DRG classifications.
• Ensure IPPS compliance and CMS guidelines when determining DRG assignment.
• Verify accuracy of diagnoses, procedures, POA indicators, and discharge disposition.
• Identify documentation gaps and collaborate with clinical teams for clarifications.
• Mentor and coach coding staff on complex DRG and inpatient coding scenarios.
• Deliver feedback and education to coders and CDI specialists to improve quality.
• Perform routine coding quality audits and recommend corrective actions.
• Analyze audit findings and prepare reports highlighting errors and improvement opportunities.
• Stay updated on regulatory changes and payer guidelines related to IPPS and inpatient coding.
• Participate in cross-functional meetings with coding, CDI, compliance, and operations teams.

Conocimientos

Medical coding

DRG coding

CDI mentoring

Descripción del empleo

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