IP DRG Auditor

Company Description

Pena4 specializes in providing revenue cycle solutions, including Clinical Documentation Integrity (CDI), Medical Billing, and Coding for healthcare organizations of all sizes. We deliver fast turnaround times, scalable solutions, and uncompromising quality to exceed industry standards. Our mission is to enhance revenue processes, enabling healthcare providers to focus on delivering exceptional patient care. At Pena4, we are committed to innovation and excellence in the healthcare domain.

Role Description

The IP DRG Auditor will be responsible for conducting audits and ensuring the accuracy of inpatient coding and DRG assignments in compliance with regulatory and organizational standards. Day-to-day tasks include reviewing medical records, identifying discrepancies, and providing feedback to improve coding quality and documentation practices. This is a full-time, on-site role located in Visakhapatnam, requiring close collaboration with internal teams and medical staff to support comprehensive and accurate revenue optimization efforts.

Qualifications

• Strong knowledge of Inpatient Coding, DRG validation, and ICD-10-CM/PCS coding guidelines.
• Skills in auditing medical records and analyzing clinical documentation to ensure compliance with coding standards.
• Proficiency in HIPAA regulations and other healthcare compliance standards.
• Attention to detail, analytical thinking, and the ability to identify and resolve inaccuracies in coding.
• Experience with coding software, electronic health records (EHR) systems, and auditing tools is preferred.
• Certified coder credentials such as CIC, CCS, or related certifications are strongly preferred.
• Bachelor's degree in Health Information Management, or a related field, or equivalent work experience.