Revenue Integrity Coder and QA in IPDRG

Eclat Health; Navi Mumbai; On-site; INR 900,000 - 1,300,000; Full time

Job summary

Eclat Health Solutions is hiring experienced Revenue Integrity IPDRG Coders for our Inpatient Revenue Integrity team. The role focuses on DRG validation, inpatient coding, and revenue integrity audits to optimize reimbursements.

We require IPDRG and Revenue Integrity experience with emphasis on documentation review and denial analysis to ensure CMS and payer compliance. Immediate to 30 days notice preferred; US shift in some teams.

Qualifications

• Experience with Revenue Integrity IPDRG and inpatient coding.
• Strong DRG validation, documentation review, and denial analysis.
• Familiarity with CMS and payer guidelines compliance.
• Proficient ICD-10-CM/ICD-10-PCS coding and audits.

Responsibilities

• Review inpatient medical records and perform DRG validation.
• Assign accurate ICD-10-CM and ICD-10-PCS codes.
• Identify documentation deficiencies and coding opportunities.
• Perform Revenue Integrity audits and validation reviews.
• Analyze DRG impacts and reimbursement opportunities.
• Support denial prevention and documentation improvement initiatives.
• Ensure compliance with CMS, MS-DRG, and payer guidelines.
• Maintain quality and productivity standards.

Skills

Revenue Integrity

IPDRG

Inpatient Coding

DRG Validation

ICD-10-CM

ICD-10-PCS

3M Encoder

Facility Coding

Coding Audits

Documentation Review

Revenue Leakage Analysis

Denial Management

Education

CCS

CPC

CIC

Tools

3M Encoder

Job description

Location: Mumbai (Work from Office)

Experience: 3 - 8 Years

Shift: US Shift

Notice Period: Immediate to 30 Days Preferred

Job Summary

Eclat Health Solutions is hiring experienced Revenue Integrity IPDRG Coders for our Inpatient Revenue Integrity team.

Revenue Integrity experience in IPDRG/Inpatient coding is mandatory.

We are looking for candidates with strong experience in DRG validation, inpatient coding audits, documentation review, coding compliance, denial analysis, and Revenue Integrity functions.

General IPDRG coders without Revenue Integrity exposure will not be contacted.

HCC, Risk Adjustment, AR Calling, Payment Posting, and Non-IPDRG profiles will not be considered.

Required Specialty Exposure

• Revenue Integrity
• IPDRG
• Inpatient Coding
• DRG Validation
• Facility Coding
• Coding Audits
• Documentation Review
• Revenue Leakage Analysis
• Coding Compliance
• Denial Analysis

Key Responsibilities

• Review inpatient medical records and perform DRG validation.
• Assign accurate ICD-10-CM and ICD-10-PCS codes.
• Identify documentation deficiencies and coding opportunities.
• Perform Revenue Integrity audits and validation reviews.
• Analyze DRG impacts and reimbursement opportunities.
• Support denial prevention and documentation improvement initiatives.
• Ensure compliance with CMS, MS-DRG, and payer guidelines.
• Maintain quality and productivity standards.

Mandatory Skills

Revenue Integrity, IPDRG, Inpatient Coding, DRG Validation, ICD-10-CM

ICD-10-PCS, 3M Encoder, Facility Coding, Coding Audits, Documentation Review, Revenue Leakage Analysis, Denial Management

Preferred Certifications, CCS, CPC, CIC