Job Family: Coding Quality IP (India) Travel Required: None Clearance Required: None What You Will Do: Plans, monitors, direct and evaluate QA production on a daily basis. Ensures that daily schedules are met and communi…
Skills: IP DRG, ICD-9-CM, CPT-4, Medical Coding, Quality Assurance
Job Family: EBO Management Information System (India) Travel Required: None Clearance Required: None What You Will Do: Gather data from primary and secondary sources, ensuring the upkeep of databases and data systems. De…
Skills: Data Analysis, Reporting, Statistics, Excel, Data Visualization
Hands-on experience in designing, developing and deploying AI/ML/NLP/GenAI/Agentic AI solutions (involving modeling, benchmarking and inferencing) at enterprise scale for e-commerce. Hands-on experience in building, eval…
Duties & Responsibilities Translate business requirements into scalable and well-documented ML pipelines and AI solutions using Databricks, Azure AI, and Snowflake. Define and drive the strategic roadmap for GenAI and ag…
Skills: Data Engineering, AI Engineering, Machine Learning, MLOps, GenAI
Duties & Responsibilities Translate business requirements into scalable and well-documented ML pipelines and AI solutions using Databricks, Azure AI, and Snowflake. Architect and implement scalable GenAI solutions using …
Duties & Responsibilities Hands-on experience in designing, developing and deploying AI/ML/NLP/GenAI/Agentic AI solutions (involving modeling, benchmarking and inferencing) at enterprise scale for e-commerce. Hands-on ex…
Role Overview We are seeking a highly skilled Lead AI/ML Engineer to design, build, and scale our next-generation Pricing & Promotion Optimization and Forecasting platform. This role sits at the intersection of machine l…
Skills: Machine Learning, AI, Statistics, Python, Time Series Modeling
Role Summary We are seeking a highly skilled Salesforce Data Engineer responsible for designing, building, and optimizing scalable data pipelines and data integration solutions across the Salesforce ecosystem and externa…
Skills: Salesforce, Azure Data Factory, Informatica PowerCenter, SQL, Python
About our Team LexisNexis Legal & Professional is a leading provider of legal data and information services. We specialise in delivering accurate, comprehensive, and timely legal content to professionals across various i…
About our Team LexisNexis Legal & Professional is a leading provider of legal data and information services. We specialise in delivering accurate, comprehensive, and timely legal content to professionals across various i…
Data Manager – Data Operations IT Department As a Data Manager in the Data Operations team, you will analyse data needs of the company and use your analytical and coding skills to maintain reliable and valid market data.…
Skills: SQL, Data Management, Market Data Analysis, Business Intelligence, Data Quality Control
Line of Service Advisory Industry/Sector Not Applicable Specialism Risk Management Level Senior Associate Job Description & Summary At PwC, our people in audit and assurance focus on providing independent and objective a…
Skills: Software Asset Management, Hardware Asset Management, Snow, Flexera, ServiceNow SAM Pro
Duties & Responsibilities Translate business requirements into scalable and well-documented ML pipelines and AI solutions using Databricks, Azure AI, and Snowflake. Define and drive the strategic roadmap for GenAI and ag…
Skills: Python, SQL, PySpark, Databricks, Azure AI
Duties & Responsibilities Hands-on lead for Salesforce tri-annual release management, including impact analysis, feature evaluation, and rollout strategy Assess, prioritize, and implement new platform features, enhanceme…
Skills: Salesforce, Apex, Lightning Web Components, Flows, API Integrations
Company Overview KLA is a global leader in diversified electronics for the semiconductor manufacturing ecosystem. Virtually every electronic device in the world is produced using our technologies. No laptop, smartphone, …
Skills: Platform Ownership, Technical Leadership, Enterprise System Implementation, SaaS Transformation, Content Management Systems
Line of Service Advisory Industry/Sector Not Applicable Specialism Risk Management Level Senior Associate Job Description & Summary At PwC, our people in audit and assurance focus on providing independent and objective a…
Skills: Software Asset Management, Hardware Asset Management, Snow, Flexera, ServiceNow SAM Pro
Project Role : Custom Software Engineer Project Role Description : Develop custom software solutions to design, code, and enhance components across systems or applications. Use modern frameworks and agile practices to de…
Are you ready to make an impact at DTCC? Do you want to work on innovative projects, collaborate with a dynamic and supportive team, and receive investment in your professional development? At DTCC, we are at the forefro…
Conduct comprehensive reviews of inpatient medical records to validate that assigned ICD-10-CM/PCS codes and DRG classifications accurately reflect the documented clinical conditions and procedures. Ensure compliance…
Plans and evaluates daily QA production for inpatient DRG coding to ensure accuracy and adherence to deadlines. Reviews medical records for correct diagnosis and procedure code assignments while providing mentorship and guidance to coding staff.
Requirements
Requires an accredited medical coder (CCA, CCS, CPC, or CPC-H) with at least 3 years of experience. Candidates should have over 5 years of experience specifically in IP DRG.
Full job description
Job Family:
Coding Quality IP (India)
Travel Required:
None
Clearance Required:
None
What You Will Do:
Plans, monitors, direct and evaluate QA production on a daily basis. Ensures that daily schedules are met and communicates with Director, and Coding Operations if situations occur that hinder meeting deadlines. If system issues or other emergencies delay QA, an implement measures/schedules to return to established schedules at the earliest possible time. This should be done closely with each quality specialist to ensure the needs are met and that satisfy our client requirements.
Responsible for ensuring that the QA communicates a valid, workable schedule for his or her client each week. Accurate, sensible & on-time.**If this doesn’t happen properly, it’s the responsibility of the Lead QA Specialist to make it happen promptly.
Review medical record documentation for accuracy in code assignment of the primary/secondary diagnosis and procedures using ICD-9-CM and CPT-4 coding conventions. Sequence the diagnosis and procedures using coding guidelines. When applicable, ensure MS-DRG/APC assignment is accurate. Abstract and compile data from medical records for appropriate optimal/complaint reimbursement for hospital and/or professional charges. This involves reviewing code assignments that are not straightforward or the documentation in the record is inadequate, ambiguous, or unclear for coding purposes.
Answers queries from the quality staff on a day to day basis and escalating to the Director of Coding as necessary.
Meets agreed sampling targets and accuracy.
Keeps abreast of coding guidelines and reimbursement reporting requirements.
Documents QA data on teams of QA/coders and records findings in the QA system (Guide Audit), which will be for reporting to the client, identifying risk areas, development of training and education programs and development/implementation of standardization within the organization. This also involves guidance and mentorship of coders.
Helps to ensure that continuing education is planned, scheduled and completed for all coding/QA teams through the coordination of the US.
Coordinates scheduled quality meetings with the QA and production staff.
Brings identified concerns to Guidehouse’s coding compliance management for discussion.
Project Launch - Active involvement in project launch sessions along with team leaders to understand the coding process.
Have a rotational arrangement and is flexible to work with any given team as assigned.
Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelines. -
Maintain a thorough understanding of anatomy and physiology, medical terminology, disease processes and surgical techniques to effectively apply ICD-9-CM and CPT-4 coding guidelines to inpatient and outpatient diagnoses and procedures.
Assist with research and development and presentation of continuing education programs on areas of specialization.
Assist with special projects as required. Example: Focused audits; client launches, etc.
What You Will Need:
Key Skills: IP DRG
Exp. Level: 5+years
Qualifications: Accredited medical coders (CCA, CCS, CPC, CPC-H) with at least 3+ years’ experience.
What Would Be Nice To Have:
Experience is Microsoft Excel, Word and PowerPoint.
What We Offer:
Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.
About Guidehouse
Guidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.
Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.
If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at [email protected]. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.
All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or [email protected]. Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.
If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse’s Ethics Hotline. If you want to check the validity of correspondence you have received, please contact [email protected]. Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant’s dealings with unauthorized third parties.
Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.
Related keywords
IP DRGICD-9-CMCPT-4MS-DRGAPCCCACCSCPCCPC-HMedical CodingQuality AssuranceGuide AuditMedical RecordsHealthcare ReimbursementAHIMAAnatomy
Empowering our clients to meaningfully shape the future.
Industry
Business Consulting and Services
Company size
10,001+ employees
Headquarters
McLean, Virginia
LinkedIn followers
290,357
Total funding
$750K
Guidehouse is a global AI-led professional services firm delivering advisory, technology, and managed services to the commercial and government sectors. With an integrated business technology approach, Guidehouse drives efficiency and resilience in the healthcare, financial services, energy, infrastructure, and national security markets. Built to help clients across industries outwit complexity, the firm brings together approximately 18,000 professionals to achieve lasting impact and shape a meaningful future.
Offices: 1676 International Dr, 800, McLean, Virginia 22102, US · 1800 Tysons Blvd, McLean, Virginia 22102, US · 1000 Wilson Blvd, Suite 1400, Arlington, Virginia 22209, US · 111 Congress Ave, Suite 2500, Austin, Texas 78701, US · 125 High St, Suite 401, Boston, Massachusetts 02110, US