Assistant Manager – Coding Auditors
EXL
full-time
Posted on:
Location Type: Hybrid
Location: India
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About the role
- Conduct detailed DRG validation audits on selected inpatient medical records to ensure coding accuracy, completeness, and compliance with ICD-10-CM/PCS, AHA Coding Clinic, and CMS guidelines.
- Review documentation to confirm that all reported diagnoses and procedures are supported and coded to the highest level of specificity.
- Validate the assignment of the discharge disposition, Present on Admission (POA) indicators, and sequencing of diagnoses.
- Identify and correct discrepancies between coded data and clinical documentation.
- Perform secondary reviews as needed for complex or disputed coding cases.
- Ensure adherence to all official coding guidelines, facility policies, and payer-specific rules.
- Monitor and analyze audit trends to identify coding or documentation issues impacting data quality and reimbursement.
- Collaborate with the Compliance Department to address audit findings and ensure regulatory adherence.
- Provide ongoing feedback and coaching to coders and Clinical Documentation Improvement (CDI) Specialists to enhance coding accuracy and documentation quality.
- Develop and deliver targeted training sessions on DRG optimization, clinical indicators, coding guidelines, and audit findings.
- Maintain detailed and accurate records of all audit activities and findings.
- Prepare periodic audit reports summarizing trends, root causes, and recommendations for improvement.
- Communicate results to management and participate in performance improvement initiatives.
- Work closely with CDI teams, physicians, and other clinical staff to clarify documentation and ensure accurate code assignment.
Requirements
- Bachelors in nursing preferable / Bachelor's in science.
- Certification- Mandatory CCS - Certified Coding Specialist, CIC - Certified Inpatient Coder
- Auditing experience on IP DRG.
- Knowledge in Microsoft outlook/excel/word.
- Exposure on 3M software and NLP tool.
Benefits
- EXL never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process and has not authorized any agencies or partners to collect any fee or payment from prospective candidates.
- EXL will only extend a job offer after a candidate has gone through a formal interview process with members of EXL’s Human Resources team, as well as our hiring managers.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
DRG validationICD-10-CMICD-10-PCScoding accuracycoding compliancedischarge disposition assignmentaudit trend analysisclinical documentation improvementcoding guidelinesaudit reporting
Soft Skills
collaborationcoachingcommunicationfeedback provisiontraining developmentproblem-solvingattention to detailorganizational skillsperformance improvementinterpersonal skills
Certifications
Certified Coding Specialist (CCS)Certified Inpatient Coder (CIC)