Job Title: IPDRG Clinical Validator
Job Overview
We are seeking an experienced and detail-oriented IPDRG Clinical Validator to join our healthcare operations team. The ideal candidate will be responsible for validating inpatient DRG assignments, reviewing medical records for coding accuracy, and ensuring compliance with clinical documentation and industry standards. Candidates must possess strong analytical skills, sound clinical knowledge, and expertise in DRG validation processes.
Mandatory Requirements
- CCCS certification is mandatory.
- 2–5 years of experience in DRG Validation/IPDRG Clinical Validation.
- Strong knowledge of ICD-10-CM, ICD-10-PCS, and MS-DRG methodologies.
- Experience in inpatient medical coding and clinical documentation review.
- Excellent attention to detail and quality-focused mindset.
Key Responsibilities
- Review inpatient medical records to validate assigned DRGs and ensure coding accuracy.
- Verify principal diagnoses, secondary diagnoses, complications, comorbidities, and procedures.
- Ensure compliance with ICD-10-CM, ICD-10-PCS, and MS-DRG guidelines.
- Identify coding discrepancies and recommend appropriate corrections.
- Collaborate with coding teams, physicians, and quality analysts to resolve documentation gaps.
- Maintain productivity and quality standards as defined by organizational policies.
- Participate in internal audits, quality initiatives, and continuous process improvement activities.
- Stay updated on changes to coding regulations, DRG methodologies, and payer requirements.
Required Skills
- Strong understanding of DRG validation concepts and methodologies.
- Proficiency in inpatient medical coding practices.
- Excellent clinical interpretation and analytical skills.
- Ability to review and interpret complex medical documentation.
- Strong communication and collaboration skills.
- Good knowledge of healthcare compliance and quality standards.
- Proficiency in MS Office applications.
Qualifications
- Bachelor's degree in Nursing, Life Sciences, Pharmacy, or a related healthcare discipline.
- CCS certification (Mandatory).
- Additional certifications in medical coding will be an advantage.
Job Title: IPDRG Clinical ValidatorJob Overview
We are seeking an experienced and detail-oriented IPDRG Clinical Validator to join our healthcare operations team. The ideal candidate will be responsible for validating inpatient DRG assignments, reviewing medical records for coding accuracy, and ensuring compliance with clinical documentation and industry standards. Candidates must possess strong analytical skills, sound clinical knowledge, and expertise in DRG validation processes.
Mandatory Requirements
- CCCS certification is mandatory.
- 2–5 years of experience in DRG Validation/IPDRG Clinical Validation.
- Strong knowledge of ICD-10-CM, ICD-10-PCS, and MS-DRG methodologies.
- Experience in inpatient medical coding and clinical documentation review.
- Excellent attention to detail and quality-focused mindset.
Key Responsibilities
- Review inpatient medical records to validate assigned DRGs and ensure coding accuracy.
- Verify principal diagnoses, secondary diagnoses, complications, comorbidities, and procedures.
- Ensure compliance with ICD-10-CM, ICD-10-PCS, and MS-DRG guidelines.
- Identify coding discrepancies and recommend appropriate corrections.
- Collaborate with coding teams, physicians, and quality analysts to resolve documentation gaps.
- Maintain productivity and quality standards as defined by organizational policies.
- Participate in internal audits, quality initiatives, and continuous process improvement activities.
- Stay updated on changes to coding regulations, DRG methodologies, and payer requirements.
Required Skills
- Strong understanding of DRG validation concepts and methodologies.
- Proficiency in inpatient medical coding practices.
- Excellent clinical interpretation and analytical skills.
- Ability to review and interpret complex medical documentation.
- Strong communication and collaboration skills.
- Good knowledge of healthcare compliance and quality standards.
- Proficiency in MS Office applications.
Qualifications
- Bachelor's degree in Nursing, Life Sciences, Pharmacy, or a related healthcare discipline.
- CCCS certification (Mandatory).
- Additional certifications in medical coding will be an advantage.
Experience of relevant experience in IPDRG/DRG Clinical Validation.
Location
- Hyderabad (or as applicable)
Employment Type
- Full-time
- 2–5 years of relevant experience in IPDRG/DRG Clinical Validation.
Pay: Up to ₹600,000.00 per year
Benefits:
Work Location: In person
