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1 ZignaAI Job

DRG Auditing Specialist

2-3 years

Hyderabad / Secunderabad

1 vacancy

DRG Auditing Specialist

ZignaAI

posted 1mon ago

Job Description

Our organization is seeking a detail-oriented DRG Auditing Specialist. This role focuses on analyzing health data, performing DRG audit quality reviews. The ideal candidate will hold a coding credential from AHIMA or AAPC, have completed coursework in medical terminology, anatomy, and physiology, and have relevant experience in DRG with a deep understanding of coding guidelines, payor guidelines, and contracts.
Responsibilities:
  • Perform comprehensive audits using ICD-10-CM, ICD-10-PCS, CPT, and HCPCS codes.
  • Ensure compliance with healthcare regulations and maintain awareness of industry changes.
  • Generate and present detailed reports on audit findings and recommendations for improved DRG auditing.
  • Support in researching and documenting inpatient audits to enable reimbursement accuracy.
  • Possess the ability to work with a cross-functional team and communicate the DRG audit results clearly.
  • Other duties as assigned as needed by your leadership to support the program.
Qualifications:
  • Active coding credential from AHIMA or AAPC (RHIA, RHIT, CCS, CCS-P, CIC, COC, CPC). A degree in a healthcare-related field is a plus.
  • Minimum of 2-3 years of experience conducting DRG and/or APC audits.
  • In-depth knowledge of coding guidelines, payor guidelines, and contracts.
  • Proven ability in managing time and prioritizing work effectively.
  • Excellent written and verbal communication skills.
  • In-office position on mid-shift.
  • Experience with AI programming, particularly in machine learning and deep learning models, is a plus.

Employment Type: Full Time, Permanent

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1mon ago·via naukri.com
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