Job Description

About the Role

AdeptMed Healthcare Solutions LLP is seeking an experienced

DRG Reviewer / Clinical Documentation Specialist (CDS)

with

NCLEX-RN (USA)

or

Registered Nurse (RN)

credentials to join our

US Healthcare Quality & Audit

team.
You will be responsible for reviewing clinical documentation, validating DRG assignments, and ensuring compliance with

CMS, ICD-10-CM, and PDPM

standards for hospital and SNF settings.

Key Responsibilities

Perform

clinical documentation reviews

and validate assigned

Diagnosis Related Groups (DRGs)

for accuracy and compliance. Review

inpatient and outpatient records

to ensure correct coding and medical necessity. Collaborate with

coding, MDS, and clinical teams

to resolve documentation discrepancies. Ensure alignment with

CMS, AHA Coding Clinic, and UHDDS

guidelines. Identify documentation deficiencies and provide feedback for improvement. Support

Clinical Documentation Improvement (CDI)

initiatives to enhance coding accuracy and case mix index (CMI). Prepare

audit summaries, reports, and recommendations

to optimize quality and revenue integrity. Maintain up-to-date knowledge of

ICD-10-CM, MS-DRG, and PDPM

rules. Ensure adherence to

HIPAA

and patient confidentiality standards.

Qualifications & Experience

Education:

Registered Nurse (RN)

- NCLEX-RN Licensed (USA)

is mandatory.

Bachelor's or Master's Degree in Nursing (

B.Sc. / M.Sc. Nursing

) from a recognized institution.

Experience:

3-8 years

of experience in

Clinical Documentation Review, DRG Validation, or Medical Record Auditing.

Prior experience in

US Healthcare, CDI, or Quality Review

strongly preferred.

Certifications (Preferred):

NCLEX-RN (USA) - Mandatory*
CCDS / CDIP / CCS / CPC - Preferred*
Familiarity with

ICD-10-CM, MS-DRG, PDPM, and CMS guidelines

Key Skills

DRG Validation Clinical Documentation Improvement (CDI) NCLEX-RN (USA)
ICD-10 Coding PDPM CMS Guidelines Medical Record Audit
Case Mix Index (CMI) Quality Review Nursing Audit US Healthcare Process

Perks & Benefits

Competitive salary based on US Healthcare experience. 5-day working week (

Saturday & Sunday off

). Health insurance and flexible schedule. Growth opportunities in the

US Healthcare Audit & CDI domain.

Supportive and collaborative work environment.

To Apply:

Send your resume to

info@adeptmed.in

Job Types: Full-time, Permanent

Pay: ₹386,618.73 - ₹647,161.58 per year

Benefits:

Flexible schedule Health insurance Leave encashment Paid sick time
Work Location: In person