EXL
Location
Chennai | India
Job description
DRG QA Auditor
A DRG Quality Auditor performs QC reviews of the internal audit team's DRG validation coding. They check the medical records and/or other documentation to ensure the DRG/coding assignment is correct and complete based on the clinical evidence, review methodologies, and contract specifications. They document and report the review results, provide clinical/policy/regulatory justification for the determination, and give feedback to the auditors in a polite and helpful way. They are familiar with ICD-10-CM & PCS coding guidelines and AHA Coding Clinics and CMS IPPS rules and regulations and have proficiency in both MS and APR DRG methodology preferred. Job Duties And Responsibilities The Quality Control Auditor will review previously audited claims for any missed opportunities or errors.Job tags
Salary
