Revenue Integrity - IPDRG

Eclat Health Solutions; Mumbai; On-site; INR 8,451,000 - 12,207,000; Full time

Job summary

Eclat Health in Mumbai (India) is seeking a Revenue Integrity Quality Analyst (QA) to review inpatient coding and DRG assignments in a US shift. The role demands solid coder and QA experience and a strong understanding of ICD-10-CM/PCS.

You will perform DRG validation, identify missed MCC/CC opportunities, analyze downgrades and payer findings, and support CDI and Coding teams to improve documentation integrity, while ensuring compliance with Coding Clinic, CMS, and industry guidelines.

Qualifications

• 3 to 8 years coding experience
• 6 to 12 years QA experience
• Experience in inpatient coding and DRG assignments

Responsibilities

• Review and validate inpatient coding and DRG assignment.
• Perform DRG validation and revenue integrity audits.
• Identify missed MCC/CC opportunities.
• Validate ICD-10-CM and ICD-10-PCS code assignment.
• Analyze DRG downgrades, denials, and payer audit findings.
• Support CDI and Coding teams to improve documentation integrity.
• Ensure compliance with Coding Clinic, CMS, and industry guidelines.

Skills

Revenue Integrity

Quality Analyst

DRG auditing

ICD-10-CM/PCS

Job description

• 1 Revenue Integrity Quality Analyst (QA)

Location

Experience

• Coder: 3 to 8 Years
• QA: 6 to 12 Years

Shift

US Shift

Job Responsibilities

• Review and validate inpatient coding and DRG assignment.
• Perform DRG validation and revenue integrity audits.
• Identify missed MCC/CC opportunities.
• Validate ICD-10-CM and ICD-10-PCS code assignment.
• Analyze DRG downgrades, denials, and payer audit findings.
• Support CDI and Coding teams to improve documentation integrity.
• Ensure compliance with Coding Clinic, CMS, and industry guidelines.