Executive Auditor, DRG
EXL
full-time
Posted on:
Location Type: Hybrid
Location: Chennai • India
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About the role
- 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 methodology, CMS guidelines, and official coding rules when determining DRG assignment.
- Verify accuracy and specificity of diagnoses, procedures, POA indicators, and discharge disposition.
- 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 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.
Requirements
- Bachelors in nursing preferable / bachelor’s in science.
- Certification- Mandatory CCS - Certified Coding Specialist, CIC - Certified Inpatient Coder
- Minimum 2 years’ experience in IP DRG coding or auditing.
- Auditing experience on IP DRG.
- Knowledge in Microsoft outlook/excel/word.
- Exposure on 3M software and NLP tool.
Benefits
- Health insurance
- Paid time off
- Flexible work arrangements
- Professional development
- Mentoring and coaching opportunities
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
ICD-10-CMICD-10-PCSDRG classificationcoding quality auditsdocumentation improvementcoding accuracyclinical codingauditingdata analysisregulatory compliance
Soft Skills
mentoringcoachingcollaborationcommunicationfeedback deliveryproblem-solvingattention to detailorganizational skillsleadershiptraining
Certifications
CCS - Certified Coding SpecialistCIC - Certified Inpatient Coder