Senior Manager Coding - IPDRG (Payer Side)

Access Healthcare; Chennai; On-site; INR 3,500,000 - 7,000,000; Full time

Job summary

Access Healthcare in Chennai is seeking a senior IP-DRG analyst with 12+ years of inpatient DRG/payer experience to lead the DRG appeals program. You will ensure accurate MS-DRG/APR-DRG assignments and MCC/CC capture under ICD-10-CM guidelines, and work from the Chennai office.

The role requires AHIMA CCS, hands-on payer DRG work, and the ability to manage a Manila-based team during their shift. You will review records, analyze denials, and drive corrective actions.

Qualifications

• 12+ years of experience in inpatient DRG/payer side work.
• CCS certification from AHIMA is required.
• Willing to work from Chennai office.
• Lead end-to-end inpatient DRG appeals programs.
• Ensure accurate MS-DRG/APR-DRG assignments and MCC/CC capture.

Responsibilities

• Lead end-to-end inpatient DRG appeals program across payors.
• Review medical records to confirm documentation supports DRG.
• Analyze denial reasons and implement corrective actions.
• Manage Manila team during the beginning of their shift.

Skills

IP DRG appeals

Payer guidelines

MS-DRG/APR-DRG

ICD-10-CM guidelines

Regulatory guidelines

DRG appeals leadership

Job description

Preference: Immediate joiners or candidates available to join within 30 days

Experience: 12+ Years

• Should have hands-on experience in the IPDRG - Payer side
• Hands-on experience in handling multiple payors and writing IP DRG appeal letters.
• Strong payor-specific guidelines understanding, ICD-10-CM Official Guidelines for Coding and Reporting, AHA Coding Clinics, and all other regulatory guidelines.
• Lead end-to-end inpatient DRG appeals program, covering DRG downgrades, clinical validation denials, and coding validation denials from all payors.
• Ensure every appeal is backed by accurate MS-DRG and APR-DRG assignment, correct principal diagnosis selection, and proper MCC/CC capture under ICD-10-CM/PCS Official Guidelines and Coding Clinic.
• Direct the review of medical records to confirm documentation supports the billed DRG and decide when a denial should be accepted rather than appealed.
• Analyze denial reasons, change rate and other quality parameters and implement corrective action plans.
• Available to manage Manila team during the beginning of their shift.
• Must have CCS from AHIMA and be ready to work from Chennai office.