1. Senior Manager/Associate Director/Deputy Director/ Director who have worked in the IP DRG payor side.

2. Hands-on experience in handling multiple payors and writing IP DRG appeal letters.

3. Solid payor-specific guidelines understanding: ICD-10-CM Official Guidelines for Coding and Reporting, AHA Coding Clinics, and all other regulatory guidelines.

4. Lead end-to-end inpatient DRG appeals program, covering DRG downgrades, clinical validation denials, and coding validation denials from all payors.

5. 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.

6. Direct the review of medical records to confirm documentation supports the billed DRG and decide when a denial should be accepted rather than appealed.

7. Analyze denial reasons, change rate and other quality parameters and implement corrective action plans.

8. Available to manage Manila team during the beginning of their shift.

9. Must have CCS from AHIMA and ready to work from Chennai office.

📌 Senior Manager/Associate Director/Deputy Director/ Director (Chennai)
🏢 Access Healthcare
📍 Chennai