Job Description

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JOB DESCRIPTION
The DRG Quality Analyst is responsible for performing an in-depth quality review of inpatient medical records to ensure that the DRG Auditor validated the billed diagnoses, POA, procedures, discharge disposition and DRG codes in accordance with the medical record documentation and in compliance with IPPS methodology. Quality Analyst is responsible for mentoring and training the DRG Auditors to reach the quality SLA. Provide ongoing feedback and education to coding staff.
ESSENTIAL CRITERIA:

• Bachelors in science/ Bachelors in nursing
• Certified - CCS - Certified Coding Specialist, CIC - Certified Inpatient Coder, CPC - Certified Professional
• Minimum 5 years experience in IP DRG coding or auditing.
• Minimum 1- 2 years' experience in Quality.

• Auditing experience on IP DRG.
• Knowledge in Microsoft outlook/excel/word.
• Exposure on 3M software and NLP tool.

• Follow every aspect of SOP without fail.
• Complete received Audits for quality review and ensure quality output.
• To achieve Quality SLA and quality production target.
• Excellent verbal and written communication.
• Follow project related protocols and instructions.
• Escalate issues, identify error trends.
• Update all the required monitoring trackers.
• All emails from Leads/Manager should be answered promptly without fail.
• Ensure to adhere with HIPAA compliance.
• Good excel skills.
• Flexibility
• Good Communication