Assistant Manager-Auditors-DRG

Job Description

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

4 years to 12 years’ experience in medical coding IVR and General surgery

Working in Quality team is an added advantage.

Minimum 5 years of experience in Inpatient DRG coding or auditing.

Minimum 1–2 years of experience in a Quality Analyst or Quality Auditing role.

Preferred Qualifications (Desirable Criteria)

Prior experience conducting IP DRG quality audits.

Hands-on exposure to 3M encoder software and NLP tools.

Strong proficiency in Microsoft Excel, including trackers, analysis, and reporting.

Experience working in SLA-driven, high-compliance healthcare environments.

Communication: Strong written (documentation) and oral communication skills

Working Hours:

40 hours per week as Full-time employee

Shift time: 08:00AM TO 05:00PM IST

Weekends Off

Telecommuter/Internet requirements, if applicable:

High Speed internet connection at home, must be broadband

Must understand and adhere with telecommuter policy