EXL

Analyzes business data and runs outsourced operations

Assistant Manager - Coding Auditors

Clinical Support & Patient AdministrationConfirmed live in the last 24 hours

Full-timeChennai, Tamil Nadu, IndiaNo salary listedIn-person

About the Job

Requirements

A Bachelor's degree in Nursing or a Bachelor's degree in Science is required or preferred as specified in the qualifications.
Mandatory certification as a Certified Coding Specialist or Certified Inpatient Coder is required.
Experience auditing inpatient diagnosis-related groups is required.
Knowledge of Microsoft Outlook, Microsoft Excel, and Microsoft Word is required.
Exposure to 3M software and a natural language processing tool is required.
Good Excel skills are required.
Flexibility is required.
Good communication skills are required.

Responsibilities

Conduct detailed diagnosis-related group validation audits on selected inpatient medical records to ensure coding accuracy, completeness, and compliance with International Classification of Diseases, Tenth Revision, Clinical Modification/Procedure Coding System, AHA Coding Clinic, and Centers for Medicare & Medicaid Services guidelines.
Review documentation to confirm that all reported diagnoses and procedures are supported and coded to the highest level of specificity.
Validate discharge disposition, Present on Admission indicators, and diagnosis sequencing.
Identify and correct discrepancies between coded data and clinical documentation.
Perform secondary reviews for complex or disputed coding cases as needed.
Ensure adherence to official coding guidelines, facility policies, and payer-specific rules.
Monitor and analyze audit trends to identify coding or documentation issues affecting data quality and reimbursement.
Collaborate with the Compliance Department to address audit findings and ensure regulatory adherence.
Provide ongoing feedback and coaching to coders and Clinical Documentation Improvement Specialists.
Develop and deliver targeted training on diagnosis-related group optimization, clinical indicators, coding guidelines, and audit findings.
Serve as a resource for complex coding questions and interpret regulatory updates and coding guideline changes.
Maintain detailed and accurate records of audit activities and findings.
Prepare periodic audit reports summarizing trends, root causes, and recommendations for improvement.
Communicate audit results to management and participate in performance improvement initiatives.
Work with Clinical Documentation Improvement teams, physicians, and other clinical staff to clarify documentation and ensure accurate code assignment.
Partner with information technology and data analytics teams to improve coding and auditing processes.
Follow every aspect of the standard operating procedure.
Complete received audits with quality.
Achieve quality and production targets.
Follow project-related protocols and instructions.
Escalate issues and identify trends.
Update productivity, clarification, and other applicable logs daily.
Check with the manager or team lead when clarification is needed.
Answer all manager emails promptly.
Ensure the entire team complies with HIPAA and the Office of Inspector General requirements.

1. Coding Audit and Review

Conduct detailed DRG validation audits on selected inpatient medical records to ensure coding accuracy, completeness, and compliance with ICD-10-CM/PCS, AHA Coding Clinic, and CMS guidelines.

Review documentation to confirm that all reported diagnoses and procedures are supported and coded to the highest level of specificity.

Validate the assignment of the discharge disposition, Present on Admission (POA) indicators, and sequencing of diagnoses.

Identify and correct discrepancies between coded data and clinical documentation.

Perform secondary reviews as needed for complex or disputed coding cases.

2. Compliance and Quality Assurance

Ensure adherence to all official coding guidelines, facility policies, and payer-specific rules.

Monitor and analyze audit trends to identify coding or documentation issues impacting data quality and reimbursement.

Collaborate with the Compliance Department to address audit findings and ensure regulatory adherence.

3. Education and Mentoring

Provide ongoing feedback and coaching to coders and Clinical Documentation Improvement (CDI) Specialists to enhance coding accuracy and documentation quality.

Develop and deliver targeted training sessions on DRG optimization, clinical indicators, coding guidelines, and audit findings.

Serve as a resource for complex coding questions and provide interpretation of regulatory updates and coding guideline changes.

4. Reporting and Documentation

Maintain detailed and accurate records of all audit activities and findings.

Prepare periodic audit reports summarizing trends, root causes, and recommendations for improvement.

Communicate results to management and participate in performance improvement initiatives.

5. Collaboration

Work closely with CDI teams, physicians, and other clinical staff to clarify documentation and ensure accurate code assignment.

Partner with IT and data analytics teams to improve coding and auditing processes.

Skills and abilities:

Qualifications: Bachelors in nursing preferable / Bachelor's in science.
Certification- Mandatory CCS - Certified Coding Specialist, CIC - Certified Inpatient Coder

• Auditing experience on IP DRG.

• Knowledge in Microsoft outlook/excel/word.

• Exposure on 3M software and NLP tool.

ADDITIONAL AND ESSENTIAL RESPONSIBILITIES:

• Follow every aspect of SOP without fail

• Complete received Audits with Quality

• To achieve Quality and production target

• Follow project related protocols and instructions

• Escalate issues, identify trends...

• Update all the logs like productivity, Clarification log, and any other logs applicable, daily

• Check with Manager /TL in case of clarifications

• All emails from Manager should be answered promptly without fail

• Ensure compliance of entire team for HIPAA,OIG

• Good excel skills

• Flexibility

• Good Communication

About the Company

EXL

Analyzes business data and runs outsourced operations

EXL analyzes business data and runs outsourced operations for insurers, healthcare payers, banks, retailers, and other large organizations. Its teams combine industry expertise with data engineering and AI to handle tasks such as claims processing, payment reviews, customer service, and finance within existing technology environments. The company also builds software, including LifePRO, which manages insurance policies, and EXLdata.ai, which connects fragmented data for use in AI systems. Clients pay for consulting projects, ongoing managed services, and software delivered through the cloud. EXL was founded in 1999 and is headquartered in New York City.

Company size: 10,001+
Company stage: IPO
Headquarters: New York City, New York
Founded: 1999

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