IPDRG QAs Raghav IT Solution Services OPC Pvt. Ltd

4.0 - 8.0 years

0 Lacs

chennai, tamil nadu

On-site

The IPDRG QA role involves conducting quality assurance reviews of inpatient medical records to ensure accurate assignment of DRGs, ICD-10-CM/PCS codes, and adherence to coding and clinical documentation standards. This position plays a crucial role in upholding compliance with federal coding guidelines, regulatory mandates, and maintaining revenue cycle integrity. Key responsibilities of the role include conducting retrospective and concurrent quality reviews of inpatient coding and DRG assignments, validating the accuracy and completeness of coding based on clinical documentation, auditing DRG assignments to ensure appropriate severity of illness (SOI), risk of mortality (ROM), and reimbursement, collaborating with coding teams and clinical documentation specialists to address discrepancies, providing feedback and training to coders on errors, trends, and best practices, ensuring compliance with CMS guidelines, AHA Coding Clinic guidance, and facility policies, staying updated on coding changes, DRG grouping logic, and regulatory requirements, utilizing computer-assisted coding (CAC) tools, encoder systems, and EHRs for audits, assisting in developing quality improvement plans based on audit findings, and generating reports and dashboards for leadership on coding accuracy and DRG performance metrics. The qualifications required for this role include holding RHIA, RHIT, CCS, or equivalent AHIMA certification, having a minimum of 3-5 years of inpatient coding and/or DRG auditing experience, possessing in-depth knowledge of ICD-10-CM/PCS, DRG reimbursement methodologies, and CMS regulations, demonstrating strong analytical, problem-solving, and communication skills, and having experience with hospital information systems, EHRs, and CAC tools such as 3M and Optum. This is a full-time position that necessitates a Bachelor's degree. Applicants must have at least 3 years of experience as an IPDRG QA and hold CPC, CCS, or CIC certification. The work location for this role is in Bangalore, Karnataka, and it requires in-person presence. For further details or to discuss the job opportunity, please contact the employer at +91 9570805386.,

Posted 1 week ago

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