Junior DRG Validation Coder Job Overview: We are looking for a dedicated and detail-oriented Junior DRG Validation Coder to join our DRG coding team. In this role, you will work closely with senior coders and Quality Analysts to ensure accurate DRG coding for medical services. This is an excellent opportunity for someone looking to develop their coding skills in a supportive and collaborative environment. Responsibilities and Duties: Assist in assigning DRG codes to medical procedures and diagnoses under the guidance of senior coders. Review medical records for completeness and accuracy, seeking guidance when necessary. Collaborate with the coding team to resolve coding-related queries and discrepancies. Participate in training programs to enhance your coding skills and understanding. Stay informed about changes in DRG coding practices and regulations. Contribute to audits and quality improvement initiatives. Qualifications: Bachelor's degree in Health Information Management, Nursing, Medicine (MBBS), Dental Surgery (BDS), Homeopathy (BHMS), or a related field (Life Science). Interest in pursuing Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) certification. Basic knowledge of medical terminology and coding principles. Strong attention to detail. Willingness to learn and adapt in a dynamic healthcare coding environment. Effective communication skills and ability to work collaboratively. Job Types: Full-time, Permanent Pay: Up to ₹500,000.00 per year Work Location: In person
Job Description: Outpatient Payment Validation Analyst / Revenue Integrity Specialist Department: Revenue Cycle / Payment Integrity Reports To: Manager, Payment Validation & Clinical Audits Role Summary We are seeking a highly analytical Outpatient Payment Validation Analyst to ensure accurate reimbursement for outpatient facility claims. This role requires strong expertise in coding, payment methodologies, and grouper logic to validate claim payments, identify variances, and support revenue integrity. Core Competencies Candidates must have solid knowledge of: OPPS: Medicare outpatient payment rules, status indicators, Composite APCs, device-dependent procedures. APC: Understanding of code-to-APC mapping and reimbursement impact. EAPG: Experience with 3M™ EAPG logic, including packaging, consolidation, discounting, and significant procedures. Grouper Logic: Ability to use grouper tools to analyze and troubleshoot claim assignments. Key Responsibilities Validate outpatient claims, APC/EAPG assignments, NCCI edits, MUEs, and OCE logic. Identify payment variances from incorrect coding, missing modifiers, or charge capture issues. Use grouper software to analyze packaging logic and complexity adjustments (e.g., J1/J2). Ensure compliance with payer policies and updates (Medicare, Medicaid, Commercial). Review claims against Inpatient Only List and other regulatory requirements. Qualifications Education: Bachelor’s in Healthcare Administration, HIM, Life Sciences, or related field. Certifications: Required: CPC or COC Preferred: CIC or CCS Experience: 4+ years in outpatient coding or revenue integrity with OPPS/EAPG auditing experience. Familiarity with 3M™ Encoder or similar grouping tools. Technical Skills Strong Excel skills (Pivot Tables, VLOOKUP). Understanding of Revenue Codes and payment impact. Ability to interpret EOBs and remittance advice. Job Types: Full-time, Permanent Pay: Up to ₹700,000.00 per year Work Location: In person
Junior DRG Validation Coder Job Overview: We are looking for a dedicated and detail-oriented Junior DRG Validation Coder to join our DRG coding team. In this role, you will work closely with senior coders and Quality Analysts to ensure accurate DRG coding for medical services. This is an excellent opportunity for someone looking to develop their coding skills in a supportive and collaborative environment. Responsibilities and Duties: Assist in assigning DRG codes to medical procedures and diagnoses under the guidance of senior coders. Review medical records for completeness and accuracy, seeking guidance when necessary. Collaborate with the coding team to resolve coding-related queries and discrepancies. Participate in training programs to enhance your coding skills and understanding. Stay informed about changes in DRG coding practices and regulations. Contribute to audits and quality improvement initiatives. Qualifications: Bachelor's degree in Health Information Management, Nursing, Medicine (MBBS), Dental Surgery (BDS), Homeopathy (BHMS), or a related field (Life Science). Interest in pursuing Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) certification. Basic knowledge of medical terminology and coding principles. Strong attention to detail. Willingness to learn and adapt in a dynamic healthcare coding environment. Effective communication skills and ability to work collaboratively. Job Types: Full-time, Permanent Pay: Up to ₹500,000.00 per year Work Location: In person
Job Overview: We are seeking an experienced and highly skilled Senior DRG Validation Coder to join our team. In this role, you will play a crucial part in ensuring the accuracy of Diagnostic Related Group (DRG) coding for medical services. Your extensive coding knowledge and attention to detail will contribute to maintaining compliance with regulations and optimizing reimbursement processes. Responsibilities and Duties: Accurately assign DRG codes to medical procedures and diagnoses in accordance with current coding guidelines and regulations. Conduct thorough reviews of medical records to ensure completeness and accuracy of documentation. Collaborate with healthcare providers and the coding team to resolve coding-related issues and discrepancies. Assist in training and mentoring junior coders to enhance their coding skills and knowledge. Stay updated on changes in DRG coding practices and regulations to ensure ongoing compliance. Participate in regular audits to assess and improve the quality of coded data. Provide expertise in coding complex cases and assist in the resolution of coding-related queries. Qualifications: Bachelor's degree in Health Information Management, Nursing, Medicine (MBBS), Dental Surgery (BDS), Homeopathy (BHMS), or a related field.(Life Science) Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) certification. A minimum of 3 years of experience in medical coding, with a focus on DRG validation. Proficiency in ICD-10-CM and CPT coding principles. Strong analytical and problem-solving skills. Excellent communication and interpersonal skills. Detail-oriented with a high degree of accuracy. Job Types: Full-time, Permanent Pay: Up to ₹700,000.00 per year Work Location: In person