3.0 - 8.0 years

6 - 16 Lacs

Hyderabad

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Role & responsibilities : Perform comprehensive inpatient DRG validation reviews to determine accuracy of the DRG billed, based on industry standard coding guidelines and the clinical evidence supplied by the provider in the form of medical records such as physician notes, lab tests, images (x-rays etc.), and with due consideration to any applicable medical policies, medical best practice, etc. Based on the evidence presented in the medical records, determine, and record the appropriate (revised) Diagnosis Codes, Procedure Codes and Discharge Status Code applicable to the claim. Using the revised codes, regroup the claim using provided software to determine the new DRG Where the regrouped ‘new DRG’ differs from what was originally claimed by the provider, write a customer facing ‘rationale’ or ‘findings’ statement, highlighting the problems found and justifying the revised choices of new codes and DRG, based on the clinical evidence obtained during the review Document all aspect of audits including uploading all provider communications, clinical rationale, and/or financial research Identify new DRG coding concepts to expand the DRG product. Manage assigned claims and claim report, adhering to client turnaround time, and department Standard Operating Procedures Meet and/or exceed all internal and department productivity and quality standards Recommend new methods to improve departmental procedures Achieve and maintain personal production and savings quota Preferred candidate profile : Registered Nurse licensure preferred Graduate Inpatient Coding Certification required (i.e., CCS, CIC, RHIA, RHIT) 3 – 5 years reviewing and/or auditing ICD-10 CM, MS-DRG and APR-DRG claims preferred Solid understanding of audit techniques, identification of revenue opportunities and financial negotiation with providers Experience and working knowledge of Health Insurance, Medicare guidelines and various healthcare programs Understanding of hospital coding and billing rules Clinical skills to evaluate appropriate Medical Record Coding Experience conducting root cause analysis and identifying solutions Strong organization skills with attention to detail Outstanding verbal and written communication skills

Posted 1 month ago

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IPDRG -Coder/Senior Coder - Omega Chennai Omega Healthcare

0.0 - 2.0 years

1 - 3 Lacs

Chennai

Work from Office

Dear Candidate We are looking for a highly experienced and dynamic IP DRG Coder /Senior Coder Job Title: IP DRG (Coder / Senior Coder Location: Chennai, India Experience: 1 To 10 Years (Minimum 1year in IP DRG specialization) Requirements:- Over 1 to 10 + years of experience in medical coding, exclusively in IP DRG coding. Seeking candidates with a minimum of 10 years of experience. Proven expertise in managing P&L and driving business outcomes in Inpatient market. Certification in medica coding ( AHIMA or AAPC) added advantage Join our team at Chennai location Work from Office Interested candidates, Get in touch 7397647886 (mobile and watsapp) for a further information. Contact Person: HR Rumal Sakthi - 7397647886 Email id - Rumal.Sakthi@omegahms.com Regards, Rumal Manager - TA

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IP DRG Service Delivery Head - Coronis AJuba!!! Coronis Ajuba Solutions

12.0 - 19.0 years

20 - 35 Lacs

Chennai

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Greetings from Coronis Ajuba !!! We are looking for a highly experienced and dynamic IP DRG Service Delivery Head to lead and manage end-to-end service delivery operations . Job Title: IP DRG (Service Delivery Head) Location: Chennai, India Experience: 15+ Years (Minimum 14 years in IP DRG specialization) Requirements:- Over 15 + years of experience in medical coding, including 14 years exclusively in IP DRG coding. Seeking candidates with a minimum of 10 years of leadership experience. Should be capable of managing 100 FTEs Proven expertise in managing P&L and driving business outcomes in Inpatient market. Certification in medica colding ( AHIMA or AAPC) is mandatory Six sigma or PMP certification is preferred Join our team at Chennai location Interested candidates, Get in touch 9840337796 (mobile and watsapp) for a telephonic interviews Contact Person : HR Mahalakshmi Regards, Mahalakshmi C Senior Lead HR - Coronis Ajuba

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