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 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:

• 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