About the Client:We are hiring for a fast-growing, US-based healthcare technology product organization with $1.5 billion revenue and 22% YoY growth. They offer cutting-edge solutions for healthcare payers and providers, including payment integrity, network analytics, provider credentialing, and engagement platforms.Role Overview: Inpatient DRG ReviewerWe are looking for certifiedInpatient DRG Reviewerswho can conduct comprehensive inpatient DRG validation reviews to ensure accurate coding and maximum payment integrity.Key Responsibilities: Performcomprehensive inpatient DRG validations(Pre-Payment, Post-Payment reviews). Review medical records, physician notes, lab tests, imaging reports, etc., and validate againstICD-10 CM, MS-DRG, APR-DRGguidelines. Assign/revise appropriateDiagnosis Codes, Procedure Codes, Discharge Status Codes . Utilize specialized software to regroup DRG codes. Document audit findings with clear rationale and communicate coding changes. Maintain high accuracy, compliance, and turnaround standards. Support internal savings targets and recommend process improvements.Required Skills & Certifications: Certification:CIC or CCS (Mandatory) ; RHIA/RHIT also acceptable. 3-10 years of experience inICD-10 CM, MS-DRG, APR-DRG coding/reviewing . Knowledge ofUS healthcare regulations, Medicare guidelines, medical billing & coding . Strong clinical review and coding audit skills. Experience in root cause analysis, audit reporting, and negotiation with providers. Excellent written & verbal communication skills. Registered Nurse (RN) license preferred but not mandatory.Why Join: ✅ Product-Based Global Healthcare SaaS Company ✅ Direct exposure to US healthcare clients ✅ Career stability with global growth ✅ Work on cutting-edge clinical coding platforms
Job Title
Medical Coder