Lead Assistant Manager-Auditors-DRG
Job Fit Check
Base Career helps you apply smarter for this job.
About the Role
Lead and manage a team of medical coding specialists, ensuring accurate and compliant auditing of DRG. Oversee workflow, training, and performance to maintain high productivity and quality standards. Stay current with coding regulations and payer policies, conduct audits to ensure compliance, and implement process improvements. Collaborate with cross-functional teams to optimize coding accuracy, payment integrity, and revenue outcomes while serving as a subject matter expert in surgery coding and auditing practices
Full Job Posting
Responsibilities
- Lead and manage a team of medical coding specialist ensuring accurate and timely auditing of procedures across various specialties in accordance with industry standards, guidelines and regulatory requirements.
- Provide guidance, training, and mentorship to the coding team, fostering a collaborative and high-performing work environment.
- Oversee the coding workflow, prioritize work assignments, and ensure productivity and quality targets are met or exceeded.
- Stay updated with changes in coding guidelines, payer policies, and industry trends related to surgery coding and payment integrity process and effectively communicate these changes to the team.
- Conduct regular audits and quality checks to ensure compliance with coding guidelines, accuracy of coded data, and adherence to documentation requirements.
- Collaborate with other departments, such as analytics, repricing, quality, compliance to optimize coding processes and resolve coding-related issues.
- Monitor key performance indicators (KPIs) and develop performance improvement initiatives to enhance auditing efficiency, accuracy, and productivity.
- Apply payment integrity processes and knowledge to ensure proper coding and billing practices, identify claim and documentation errors and deficiencies, and maximize revenue capture.
- Serve as a subject matter expert on multi-specialty surgery coding and payment integrity, providing guidance and support to physicians, clinical staff, and other stakeholders to ensure appropriate documentation, coding, and auditing practices
- - Lead and manage a team of medical coding specialist ensuring accurate and timely auditing of procedures across various specialties in accordance with industry standards, guidelines and regulatory requirements. - Provide guidance, training, and mentorship to the coding team, fostering a collaborative and high-performing work environment. - Oversee the coding workflow, prioritize work assignments, and ensure productivity and quality targets are met or exceeded. - Stay updated with changes in coding guidelines, payer policies, and industry trends related to surgery coding and payment integrity process and effectively communicate these changes to the team. - Conduct regular audits and quality checks to ensure compliance with coding guidelines, accuracy of coded data, and adherence to documentation requirements. - Collaborate with other departments, such as analytics, repricing, quality, compliance to optimize coding processes and resolve coding-related issues. - Monitor key performance indicators (KPIs) and develop performance improvement initiatives to enhance auditing efficiency, accuracy, and productivity. - Apply payment integrity processes and knowledge to ensure proper coding and billing practices, identify claim and documentation errors and deficiencies, and maximize revenue capture. - Serve as a subject matter expert on multi-specialty surgery coding and payment integrity, providing guidance and support to physicians, clinical staff, and other stakeholders to ensure appropriate documentation, coding, and auditing practices
Qualifications
- Bachelor’s degree in Clinical or Healthcare Information Management or a related field.
- Relevant certifications (e.g. CPC,CIC,CCS for DRG) are mandatory.
- Extensive experience in medical coding, with a focus on DRG coding and strong knowledge of CPT, ICD-10-CM, HCPCS coding systems.
- Proficient in using coding software and electronic health record (EHR) systems.
- Strong analytical and problem-solving skills, with the ability to identify coding-related issues, propose solutions, and implement process improvements.
- Excellent interpersonal and communication skills, with the ability to collaborate effectively with diverse stakeholders and build positive relationships.
- Detail-oriented with a commitment to accuracy and compliance with coding guidelines and regulations.
- Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment.
- Demonstrated knowledge of healthcare industry regulations such as HIPAA and HITECH, and specific knowledge of CMS, Medicare, LCDs, NCDs, Medical Policies, Commercial payer processes and requirements.
- - Bachelor’s degree in Clinical or Healthcare Information Management or a related field. - Relevant certifications (e.g. CPC,CIC,CCS for DRG) are mandatory. - Extensive experience in medical coding, with a focus on DRG coding and strong knowledge of CPT, ICD-10-CM, HCPCS coding systems. - Proficient in using coding software and electronic health record (EHR) systems. - Strong analytical and problem-solving skills, with the ability to identify coding-related issues, propose solutions, and implement process improvements. - Excellent interpersonal and communication skills, with the ability to collaborate effectively with diverse stakeholders and build positive relationships. - Detail-oriented with a commitment to accuracy and compliance with coding guidelines and regulations. - Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment. - Demonstrated knowledge of healthcare industry regulations such as HIPAA and HITECH, and specific knowledge of CMS, Medicare, LCDs, NCDs, Medical Policies, Commercial payer processes and requirements.
About EXL
EXL is a global data and AI company that provides analytics, digital operations, and industry-specific services to enterprises in insurance, healthcare, banking, retail, media, and energy.
Visit company websiteApply for this job in 1 click
Skip the repetitive application forms
Install the Base Career Chrome Extension and autofill job applications across major job boards with your profile.
Trusted by over 500,000 job seekers on Base Career
More from this employer
More jobs at EXL
Full Stack Engineer
, IND
Lead the development and maintenance of complex software applications. Duties include designing application architecture, guiding junior engineers, and ensuring high-quality deliverables. You will work closely with stake
CRM Manager (Planning), 1:1 Fan Engagement Marketing
, CAN
Position: Production Manager, 1:1 Fan Engagement Marketing Location: Remote in US and Canada Salary: $105,000-$125,000 + bonus + incentives The posted range is the hiring range for this role — a subset of the broader ran
Lead Assistant Manager_Premium Accounting Services
Noida, IND
Lead Assistant manager for Order to Cash role
Product Coordinator - MarTech Platform and Governance
, CAN
• The Product Coordinator - MarTech Platforms & Governance plays a critical role in supporting the operational scale and governance of the organization's multi-tenant MarTech ecosystem. This role is responsible for manag
Senior Specialist - UI/UX Front End Developer
, CAN
We are currently seeking an experienced Senior Specialist with 6 to 9 years of professional experience bridging modern UI/UX engineering with Adobe Experience Manager (AEM) and Adobe Edge Delivery Services (EDS). The ide
Full Stack Engineer
, IND
AWS Data Engineer
Noida, IND
CRM Manager (Planning), 1:1 Fan Engagement Marketing
, CAN
Lead Data Engineer
London, GBR
Lead Assistant Manager_Premium Accounting Services
Noida, IND
Product Coordinator - MarTech Platform and Governance
, CAN
Senior Specialist - UI/UX Front End Developer
, CAN
Executive
Noida, IND