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EXL
EXL
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EXL is a business consulting and services company that helps organizations use data, analytics, and technology to improve operations and make better decisions. Its work includes operations management, decision analytics, and digital transformation, with experience supporting clients in healthcare, insurance, finance, and logistics. EXL combines data science with practical business expertise to develop solutions tailored to each organization’s goals, operating model, and industry context.
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Senior Inpatient DRG Quality Auditor – Chennai (Hybrid)

Audits inpatient DRG coding for diagnoses, procedures, and compliance. Trains DRG auditors and meets quality SLAs in Chennai.

INIndiaHybridFull-timeSeniorEnglish RequiredAuditor

Description

  • Conduct detailed secondary quality audits of inpatient medical records reviewed by DRG auditors.
  • Check principal and secondary diagnoses, procedures, POA indicators, discharge disposition, and final DRG assignments.
  • Confirm adherence to IPPS regulations, ICD-10-CM/PCS guidelines, official coding conventions, and payer or client requirements.
  • Follow all standard operating procedures.
  • Maintain full compliance with HIPAA and data security standards.
  • Use quality tools, 3M software, NLP tools, and internal systems for audits and reporting.
  • Document and report work using Microsoft Excel, Outlook, and Word.
  • Follow project protocols, workflows, and client instructions.
  • Complete assigned audits for quality review and deliver accurate results.
  • Meet quality service-level agreements and production targets.
  • Escalate issues and spot recurring error patterns.
  • Keep monitoring trackers up to date.
  • Respond promptly to email from leads and managers.
  • Coach and train DRG auditors, providing ongoing feedback and coding education.

Requirements

  • Bachelor’s degree in science or nursing.
  • Hold at least one required certification: CCS (Certified Coding Specialist), CIC (Certified Inpatient Coder), or CPC (Certified Professional Coder).
  • At least five years of inpatient DRG coding or auditing experience.
  • At least one to two years in quality analysis or quality auditing.
  • Prior experience performing inpatient DRG quality audits is preferred.
  • Experience using 3M encoder software and NLP tools is preferred.
  • Strong Microsoft Excel skills, including trackers, analysis, and reporting.
  • Experience in healthcare environments with service-level targets and strict compliance requirements.
  • Excellent spoken and written communication skills.
  • Working knowledge of Microsoft Outlook and Word.
  • Knowledge of IPPS regulations, ICD-10-CM/PCS guidelines, official coding conventions, and payer or client requirements.
  • Ability to follow HIPAA and data security standards.
  • Ability to follow standard procedures, project protocols, workflows, and client instructions.
  • Flexibility.

Benefits

  • Hybrid work arrangement.
  • Flexible work arrangement.

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