6 Aprdrg Jobs

Role Overview: Zelis India is on a mission to enhance the healthcare financial experience and you will play a crucial role in this by supporting various initiatives. You will be responsible for performing comprehensive inpatient DRG validation Quality Assurance reviews to ensure accuracy of the DRG billed, managing claims, serving as a Subject Matter Expert on DRG validation, and identifying new DRG coding concepts to expand the DRG product. Your role will involve implementing and conducting quality assurance programs, preparing and conducting training for new team members, and recommending efficiencies and process improvements. Key Responsibilities: - Perform comprehensive inpatient DRG val...

As a Medical Biller / Coder, your role involves overseeing coding activities to ensure customer service and quality expectations are met. You will be the primary contact for coding questions related to Client Services and Operations. Your responsibilities include reviewing reports to identify specific issues, investigating and correcting them as per the coding guidelines, and implementing solutions. Additionally, you will need to proactively identify issues and plan for their resolution for clients and accounts. It is crucial to maintain compliance with HIPAA and ISO standards, adhere to company policies, and review and report on process updates and team metrics with the management team. You...

Role Overview: You will be responsible for reviewing provider disputes related to DRG Coding and Clinical Validation, Itemized Bill Review, and Clinical Chart Review. Your main tasks will include analyzing disputes, providing explanations based on findings, managing claim dispute volume, and ensuring adherence to client turnaround times and department procedures. Additionally, you will serve as a subject matter expert for the Expert Claim Review Team, creating educational materials, conducting research, and maintaining bill review content. Key Responsibilities: - Review provider disputes for DRG Coding and Clinical Validation, Itemized Bill Review, and Clinical Chart Review - Submit explanat...

As a Medical Biller / Coder, you will be responsible for overseeing coding activities to ensure customer service and quality expectations are met. You will serve as the primary contact for coding questions related to Client Services and Operations. Your role will involve reviewing reports, identifying specific issues, investigating and correcting them as per the coding guidelines, and implementing solutions. Additionally, you will proactively identify issues and plan for their resolution for clients and accounts. It will be your duty to maintain compliance with HIPAA and ISO standards, as well as adhere to company policies. You will review and report on process updates and team metrics with ...

About Us At Zelis India, our mission is to enhance the healthcare financial experience by developing and implementing innovative solutions. We are dedicated to optimizing technology and processes for efficiency and effectiveness. Our collaborative work culture, leadership development initiatives, and global exposure opportunities create a dynamic environment for professional growth. With hybrid work flexibility, comprehensive healthcare benefits, financial wellness programs, and cultural celebrations, we strive to provide a holistic workplace experience. Our team at Zelis India maintains high standards of service delivery and contributes to our award-winning culture. Position Overview As a m...

As a Provider Dispute Specialist at our organization, you will play a crucial role in reviewing provider disputes related to DRG Coding and Clinical Validation, Itemized Bill Review, and Clinical Chart Review. Your responsibilities will include submitting explanations of dispute rationale back to providers within the designated timeframe to ensure client turnaround times are met. You will be accountable for managing claim dispute volume on a daily basis, adhering to client turnaround time, and department Standard Operating Procedures. In this role, you will serve as a subject matter expert for the Expert Claim Review Team, providing support on day-to-day activities, troubleshooting, and ensu...