Assistant Manager - Coding Auditors

Chennai, Tamil Nadu
Permanent
Full-time

4 days ago

Job Category: Healthcare AuditingJob Description:1. Coding Audit and ReviewConduct detailed DRG validation audits on selected inpatient medical records to ensure coding accuracy, completeness, and compliance with ICD-10-CM/PCS, AHA Coding Clinic, and CMS guidelines.Review documentation to confirm that all reported diagnoses and procedures are supported and coded to the highest level of specificity.Validate the assignment of the discharge disposition, Present on Admission (POA) indicators, and sequencing of diagnoses.Identify and correct discrepancies between coded data and clinical documentation.Perform secondary reviews as needed for complex or disputed coding cases.2. Compliance and Quality AssuranceEnsure adherence to all official coding guidelines, facility policies, and payer-specific rules.Monitor and analyze audit trends to identify coding or documentation issues impacting data quality and reimbursement.Collaborate with the Compliance Department to address audit findings and ensure regulatory adherence.3. Education and MentoringProvide ongoing feedback and coaching to coders and Clinical Documentation Improvement (CDI) Specialists to enhance coding accuracy and documentation quality.Develop and deliver targeted training sessions on DRG optimization, clinical indicators, coding guidelines, and audit findings.Serve as a resource for complex coding questions and provide interpretation of regulatory updates and coding guideline changes.4. Reporting and DocumentationMaintain detailed and accurate records of all audit activities and findings.Prepare periodic audit reports summarizing trends, root causes, and recommendations for improvement.Communicate results to management and participate in performance improvement initiatives.5. CollaborationWork closely with CDI teams, physicians, and other clinical staff to clarify documentation and ensure accurate code assignment.Partner with IT and data analytics teams to improve coding and auditing processes.Responsibilities:ADDITIONAL AND ESSENTIAL RESPONSIBILITIES:

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, daily

Check with Manager /TL in case of clarifications

All emails from Manager should be answered promptly without fail

Ensure compliance of entire team for HIPAA,OIG

Good excel skills

Flexibility

Good Communication

Qualifications:Skills and abilities:Qualifications: Bachelors in nursing preferable / Bachelor's in science.
Certification- Mandatory CCS - Certified Coding Specialist, CIC - Certified Inpatient Coder

Auditing experience on IP DRG.

Knowledge in Microsoft outlook/excel/word.

Exposure on 3M software and NLP tool.

About Us:EXL (NASDAQ: EXLS) is a leading data analytics and digital operations and solutions company. We partner with clients using a data and AI-led approach to reinvent business models, drive better business outcomes and unlock growth with speed. EXL harnesses the power of data, analytics, AI, and deep industry knowledge to transform operations for the world's leading corporations in industries including insurance, healthcare, banking and financial services, media and retail, among others. EXL was founded in 1999 with the core values of innovation, collaboration, excellence, integrity and respect. We are headquartered in New York and have more than 54,000 employees spanning six continents. For more information, visit .EXL never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process and has not authorized any agencies or partners to collect any fee or payment from prospective candidates. EXL will only extend a job offer after a candidate has gone through a formal interview process with members of EXL's Human Resources team, as well as our hiring managers.About the Team: EXL is the indispensable partner for leading businesses in data-led industries such as insurance, banking and financial services, healthcare, retail and logistics. We bring a unique combination of data, advanced analytics, digital technology and industry expertise to help our clients turn data into insights, streamline operations, improve customer experience, and transform their business. Our partnerships with clients are built on a foundation of collaboration - and we've been chosen as a partner by nine of the top ten leading US insurance companies, nine of the top 20 global banks, and six of the top ten US health care payers. We function as one team to make your goals our goals, whether that's unlocking the value of generative AI or embedding analytics into workflows that reduce risk or power your growth. Clients choose EXL as their transformation partner for many reasons. Our geographic diversity make talent all over the world instantly accessible. Digital accelerators enable unmatched speed-to-value, letting you realize results fast. It's our people that truly set us apart, though, including the 1,500 data scientists we have dedicated to our generative AI practice. And our more than twenty years of experience in delivering business services, garnering stellar client references, and maintaining a solid balance sheet are reassuring to our C-suite clients. Find out for yourself why clients, employees, and analysts think we're some of the best in the business. Contact us to see how we can help you achieve your goals.

EXL Service

Apply Now