Assistant Manager-Auditors-DRG

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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.

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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.

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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