Inpatient DRG Coding Expert

Inpatient DRG Coding Expert:We Are Hiring: Inpatient-DRG Coding Experts – Documentation Excellence, Case Mix Index Integrity, and Reimbursement AccuracyDoctus Data Services Pvt. Ltd . is expanding its Inpatient (IP) DRG Coding practice and seeking 20+ experienced IP-DRG Coding Experts to join our growing team. This is not a standard coding role; it is an opportunity to lead denial prevention, optimize coding accuracy, and enhance Case Mix Index (CMI) while driving quality and financial outcomes for leading United States health systems.Why This Role Matters Now:· Healthcare Challenge: Rapidly rising denial rates. Your Impact: Deliver clean, audit-proof claims through proactive documentation and coding alignment that protects Case Mix Index (CMI).· Healthcare Challenge: Reimbursement compression from Medicare Advantage and commercial payers Your Impact: Optimize DRG assignment to reflect true acuity and maintain accurate CMI.· Healthcare Challenge: Quality-linked penalties (PSIs, readmissions, HACs) Your Impact: Improve coding accuracy that drives CMS quality metrics while sustaining accurate CMI.· Healthcare Challenge: AI-driven audits and automated denials Your Impact: Stay ahead with clinically nuanced, precision-driven coding that ensures CMI integrity under scrutiny.About the Role:We are seeking seasoned inpatient coding experts who translate complex clinical documentation into accurate ICD-10-CM/PCS codes and defensible MS-DRG/APR-DRG assignments. Your work will directly impact CMI, SOI, ROM, CC/MCC capture, reimbursement accuracy, quality reporting, and audit readiness. This role goes beyond assigning codes — you will partner with Client CDI teams, educate providers, and ensure that every claim reflects true acuity and resource utilization.What You Will Do:· Own Case Mix Index performance: Assure accurate CMI through precise SOI and ROM leveling and consistent CC/MCC capture across complex inpatient encounters.· Champion documentation integrity: Validate ICD-10-CM/PCS coding and final DRG assignment with a CMI-first lens.· Drive query excellence: Close documentation gaps with clinically focused, audit-ready queries that support defensible CMI uplift.· Lead compliance and education : Advise on DRG logic, POA indicators, and quality metrics (HAC, PSI, mortality), and deliver targeted provider education to sustain CMI gains.· Prevent denials proactively : Implement pre-bill workflows; conduct root-cause analyses for DRG downgrades, payer rejections, and RAC triggers to protect CMI and revenue integrity.· Analyze and act on trends : Monitor DRG shifts, outlier cases, low-acuity patterns, and under-captured CC/MCC opportunities; escalate findings with clear recommendations.· Partner for impact : Collaborate with United States revenue cycle leaders to align coding practices with value-based metrics and CMI-linked performance goals.· Stable or improving monthly CMI trend by service line· CC/MCC capture rate improvement with sustained SOI/ROM accuracy· Reduction in DRG downgrades and avoidable payer takebacks affecting CMI· Increased audit sustainment rate for clinically validated queries and DRG assignmentsTools and Platforms You Will Work With:· EMRs : EpicCare Inpatient, Oracle Cerner, Meditech· Coding and CAC: Solventum 3M 360 CAC, Microsoft/Nuance, Optum EncoderPro· Analytics : SQL-based audit tracking, Excel-based CMI and DRG-shift dashboards· Collaboration: CDI portals and denial-resolution playbooksWhat You Will Bring:· Minimum Experience: At least 8 years of hands-on United States inpatient CDI and DRG coding experience with deep expertise in ICD-10-CM/PCS, MS-DRG, and APR-DRG logic.· Education: Graduate or Postgraduate degree in Life Sciences (Physicians or Registered Nurses preferred).· Certifications: CCS, CDIP, CCDS, CIC, or equivalent (multiple credentials are a plus).· Systems Expertise: Epic, Oracle Cerner, Meditech, Solventum, Nuance, Optum.· Knowledge: HAC/PSI indicators, POA status, CMI optimization, clinical validation, and audit readiness.· Soft Skills: Strong analytical mindset, consultative communication style, and the ability to translate data into CMI-impacting actions.· Work Mode: Work From Office - Hyderabad Location.Why Join Doctus:· Impact at scale — Influence CMI, quality scores, reimbursement accuracy, and patient outcomes for leading United States health systems.· Collaborative culture — Join an expert team that values transparency, learning, and continuous growth.· Career acceleration — Access credentialing sponsorship, advanced CDI analytics, and leadership development pathways.· Comprehensive package — Industry-leading compensation, credentialing support, and performance incentives.Ready to Redefine Documentation Excellence and CMI Performance? Send your résumé or LinkedIn profile to with the subject line: “Inpatient-DRG Expert – LinkedIn.”