EXL Service
From EXL Service's careers page
Status: listed on the employer's own careers page when we last checked (daily). Confirm on their site before applying.
Conduct comprehensive reviews of inpatient medical records to validate that assigned ICD-10-CM/PCS codes and DRG classifications accurately reflect the documented clinical conditions and procedures.
Ensure compliance with IPPS (Inpatient Prospective Payment System) methodology, CMS guidelines, and official coding rules when determining DRG assignment.
Verify accuracy and specificity of diagnoses, procedures, POA indicators, and discharge disposition, ensuring documentation supports all coding decisions.
Identify documentation gaps and collaborate with clinical teams to obtain necessary clarifications for accurate code assignment.
Mentor, coach, and support coding staff, providing guidance on complex DRG and inpatient coding scenarios.
Deliver feedback and ongoing education to both coders and Clinical Documentation Improvement (CDI) specialists to improve coding quality and documentation completeness.
Perform routine coding quality audits to assess accuracy, identify trends, and recommend corrective actions.
Analyze audit findings and prepare detailed reports, highlighting errors, patterns, and opportunities for improvement.
Stay updated on regulatory changes, payer guidelines, and industry best practices related to IPPS, DRG validation, and inpatient coding.
Participate in cross-functional meetings with coding, CDI, compliance, and operations teams to strengthen documentation and coding accuracy across the organization
Follow every aspect of SOP without fail
Complete received Audits with Quality
To achieve Quality and production target
Follow project related protocols and instructions
Escalate issues, identify trends...
Update all the logs like productivity, Clarification log, and any other logs applicable, daily
Check with Manager /TL in case of clarifications
All emails from Manager should be answered promptly without fail
Ensure compliance of entire team for HIPAA,OIG
Good excel skills
Flexibility
Good Communication
Qualifications: Bachelors in nursing preferable / bachelor’s in science.
Certification- Mandatory CCS - Certified Coding Specialist, CIC - Certified Inpatient Coder
Experience: Minimum 2 years’ experience in IP DRG coding or auditing.
Working Hours: 40 HOURS PER WEEK, FULL TIME EMPLOYEE
Auditing experience on IP DRG.
Knowledge in Microsoft outlook/excel/word.
Exposure on 3M software and NLP tool.
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