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DRG Reviewer

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Zelis
πŸ“ Hyderabad, India
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Location Hyderabad
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Posted June 04, 2026
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Commute Local Area
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Job Description

Position Overview

The InpatientDRGReviewer will be primarily responsible for conducting post-service, pre-payment and post pay comprehensive inpatientDRGreviews based on industry standardinpatient codingguidelines and rules, evidence based clinical criteria plan, and policy exclusions. Conduct reviews on inpatientDRGclaims as they compare with medical records ICD-10 OfficialCodingGuidelines, AHACodingClinic and client specific coverage policies. Conduct prompt claim review to support internal inventory management to achieve greatest savings for clients. Please share relevant profiles at the earliest. Let us know if you need any further details.

We are looking for professionals with strong expertise inDRG. The ideal candidates should have:

KeyResponsibilities:

  • Perform comprehensive inpatientDRGvalidation reviews to determineaccuracyof theDRGbilled, based on industry standardcodingguidelines and the clinical evidence supplied by the provider in the for...
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    πŸ“ Location Details

    πŸŒ†
    City
    Hyderabad
    πŸ—ΊοΈ
    Country
    India
    πŸš—
    Commute
    Local Area

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