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Inpatient DRG Reviewer
Zelis
Full time
Hyderabad, Telangana
Other Healthcare Practitioners and Technical Occupations
Posted:
June 08, 2026
Location:
Hyderabad, Telangana, India
Job Description
Position Overview
As part of the Price Optimization division, this role is responsible for conducting post-service, pre-payment and post pay comprehensive inpatient DRG Quality Assurance reviews in an effort to increase the savings achieved for Zelis clients. Conduct reviews on inpatient DRG claims as they compare with medical records utilizing ICD-10 Official Coding Guidelines, AHA Coding Clinic evidence based clinical criteria and client specific coverage policies.What you will do:
Perform comprehensive inpatient DRG validation Quality Assurance reviews to determine accuracy of the DRG billed, based on industry standard coding guidelines and the clinical evidence supplied by the provider in the form of medical records such as physician notes, lab tests, images (x-rays etc.), and with due consideration to any applicable medical policies, medical best practice, etc.
Implement and conduct quality assurance program to ensure accurate results to o...
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Apply Now Save for LaterJob Overview
Job Type:
Full time
Location:
Hyderabad, India
Posted:
June 08, 2026
Deadline:
July 18, 2026