Auditing Expert

5 days ago


Noida, Uttar Pradesh, India EXL IT service management Full time

About EXL IT Service Management

We are a leading provider of IT service management solutions, dedicated to delivering exceptional results to our clients. Our team is comprised of highly skilled professionals who share a passion for innovation and excellence.

Job Description

We are seeking a Lead Assistant Manager to join our team in the position of DRG Auditor. In this role, you will be responsible for performing in-depth reviews of select inpatient medical records to ensure that the assigned codes and DRG are supported by clinical documentation. You will also be required to analyze coding trends and patterns to identify areas for improvement or potential risks.

Key Responsibilities:

  • 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:

  • Bachelor's degree in nursing or science.
  • Certification as CCS - Certified Coding Specialist or CIC - Certified Inpatient Coder.
  • Auditing experience on IP DRG.
  • Knowledge in Microsoft Outlook, Excel and Word.
  • Exposure to 3M software and NLP tool.


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