IPDRG Auditor
- Yitro Global
- 3 - 6 years
- Hyderabad
- 7 months ago
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Job Description
Job Title: Auditor - Inpatient Coding (US Healthcare)
Location: [Hyderabad]
Experience: 3 -5
Salary: Best in Industry
Employment Type: Full Time
Job Description:
We are hiring Auditors - IPDRG. Performs independent reviews, interprets medical records, and applies in-depth knowledge of coding principles to determine billing/coding/documentation issues and quality concerns. Demonstrates high level of expertise in researching requirements necessary to make compliant recommendations..
Roles & Responsibilities:
- Conducts DRG (ex. MS, APR, Tricare) coding and clinical reviews to verify the accuracy of coding, DRG assignment and clinical indicators in accordance with coding and documentation guidelines. Ensures that the assigned DRG reflects the severity of the patients condition and the resources used during their hospital stay.
- Assesses whether the clinical documentation supports the coded diagnoses and procedures. Verifies that the medical record adequately justifies the assigned DRG.
- ombines medical record coding guidelines, clinical principles, and industry trends to explain any recommended changes needed by coders. Works closely with CDI (Clinical Documentation Integrity) specialists to determine if there are documentation and/or query opportunities.
- Writes clear, accurate and concise recommendations in support of findings while providing feedback and education to acute inpatient coders, referencing current ICD-10-CM/PCS Official Coding Guidelines and AHA Coding Clinics.
Desired Candidate Profile:
- 3+ years of overall experience with 1+ years of experience in Quality Analysis within the healthcare / RCM domain.
- Strong understanding of end-to-end RCM processes including charge entry, payment posting, denial management, and AR follow-up.
- Knowledge of HIPAA and healthcare compliance standards.
- Proficiency in using billing software (e.g., Epic, Athena, Kareo) and QA tools.
- Excellent communication skills for feedback and reporting
- Attention to detail with strong analytical and problem-solving skills.
- Ability to work independently and in a team environment.
Interested Candidates can apply through Naukri.
Job Classification
Industry: BPM / BPOFunctional Area / Department: Healthcare & Life SciencesRole Category: Healthcare & Life Sciences - OtherRole: Healthcare & Life Sciences - OtherEmployement Type: Full timeContact Details:
Company: Yitro GlobalLocation(s): Hyderabad
Keyskills: Inpatient Coding Quality Audit Ip Drg Medical Coding Quality Control Ccs Quality Analysis Coc CPC Quality Check Cic Auditing
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