Overview The DRG Auditor is responsible for performing an in-depth review of select inpatient medical records to ensure that the assigned codes and DRG are supported by clinical documentation and all diagnoses and procedures are coded with the required specificity and the discharge disposition and the POA are correct Knowledge of IPPS methodology is required Responsible for mentoring and training other coders Provide ongoing feedback and education to coding staff and Clinical Documentation Specialists Review medical records to ensure accurate coding and billing practices in accordance with established guidelines and regulations Identify discrepancies errors or potential fraud in coding and billing practices Analyze coding trends and patterns to identify areas for improvement or potential risks Collaborate with stakeholders to address coding and billing issues and improve documentation practices Provide feedback and education to coding staff providers on coding guidelines documentation guidelines and regulatory changes Prepare audit reports summarizing findings recommendations and suggesting corrective and preventative actions Stay current with updates to coding guidelines regulations and industry best practices Assist in developing and implementing policies procedures and tools to support accurate coding and billing practices Qualifications Bachelors in nursing preferable Bachelor s in science Certification- Mandatory CCS - Certified Coding Specialist CIC - Certified Inpatient Coder Skills and abilities o Auditing experience on IP DRG o Knowledge in Microsoft outlook excel word o Exposure on 3M software and NLP tool ADDITIONAL AND ESSENTIAL RESPONSIBILITIES o Follow every aspect of SOP without fail o Complete received Audits with Quality o To achieve Quality and production target o Follow project related protocols and instructions o Escalate issues identify trends o Update all the logs like productivity Clarification log and any other logs applicable daily o Check with Manager TL in case of clarifications o All emails from Manager should be answered promptly without fail o Ensure compliance of entire team for HIPAA OIG o Positive excel skills o Flexibility o Good Communication

📌 Lead Assistant Manager (Uttar Pradesh)
🏢 EXL Service
📍 Uttar Pradesh