Assistant Manager-Auditors-DRG

• ADDITIONAL AND ESSENTIAL RESPONSIBILITIES:

  • Follow every aspect of SOP without fail. 
  • Complete received Audits for quality review and ensure quality output.
  • To achieve Quality SLA and quality production target.
  • Excellent verbal and written communication.
  • Follow project related protocols and instructions. 
  • Escalate issues, identify error trends.
  • Update all the required monitoring trackers. 
  • All emails from Leads/Manager should be answered promptly without fail.
  • Ensure to adhere with HIPAA compliance.
  • Good excel skills. 
  • Flexibility
  • Good Communication

Responsibilities

• Responsibilities and Essential Functions:

   

  • Perform comprehensive secondary quality audits on inpatient medical records reviewed by DRG Auditors.
  • Validate accuracy of principal and secondary diagnoses, procedures, POA indicators, discharge disposition, and final DRG assignment.
  • Ensure compliance with IPPS regulations, ICD-10-CM/PCS guidelines, official coding conventions, and payer/client-specific requirements.
  • Adhere strictly to all Standard Operating Procedures (SOPs) without deviation.
  • Ensure 100% compliance with HIPAA and data security standards at all times.
    
    Use quality tools, 3M software, NLP tools, and internal systems effectively for audit and reporting activities.
  • Demonstrate strong working knowledge of Microsoft Excel, Outlook, and Word for documentation and reporting.

  • Follow all project-specific protocols, workflows, and client instructions.

     

  • QC check
  • Follow every aspect of SOP without fail 
  • Complete received Audits with Quality
  • To achieve Quality and production target
  • Follow project related protocols  and instructions 
  • Escalate issues, identify trends...
  • Update all the logs like productivity, Clarification log, and any other logs applicable on a daily basis.
  • Check with Manager /TL in case of clarifications 
  • All emails from Manager should be answered promptly without fail
  • Problem solving skill sets
  • Ensure compliance of entire team for HIPAA,OIG

Qualifications

• Qualifications: 

  • Education - Bachelor’s Degree in Science or Nursing.

  • CPC/CPMA; Min. 3+ Years experience  After Certification

     

  1. 4 years to 12 years’ experience in medical coding IVR and General surgery
  2. Working in Quality team is an added advantage.
  3. Minimum 5 years of experience in Inpatient DRG coding or auditing.
  4. Minimum 1–2 years of experience in a Quality Analyst or Quality Auditing role.
  5. Preferred Qualifications (Desirable Criteria)
  6. Prior experience conducting IP DRG quality audits.
  7. Hands-on exposure to 3M encoder software and NLP tools.
  8. Strong proficiency in Microsoft Excel, including trackers, analysis, and reporting.
  9. Experience working in SLA-driven, high-compliance healthcare environments.

   Communication: Strong written (documentation) and oral communication skills 

  Working Hours:

  1. 40 hours per week as Full-time employee
  2. Shift time: 08:00AM TO 05:00PM IST
  3. Weekends Off

  Telecommuter/Internet requirements, if applicable:

  1. High Speed internet connection at home, must be broadband
  2. Must understand and adhere with telecommuter policy