Certifications:

Experience: 9 to 12 years experience in medical coding, auditing and automation.

Skills and Abilities:

Advanced knowledge of medical coding software platforms (e.g., 3M Code Finder, Optum360, True Code, Epic, Cerner, etc.).
Minimum 5 years of experience in Inpatient DRG coding.
Outpatient medical coding experience is added advantage.
Mandatory working experience on US healthcare automation projects.
Knowledge on automation tools
Knowledge of programming language would be added advantage alike.
Python
SQL
R, etc.
Payer experience is added advantage.
Expertise in Microsoft outlook/excel/word/Power BI.

Primary Roles and Responsibilities:

Automation of DRG Coding to streamline repetitive coding tasks.
Bringing AI based solutions for DRG claims validations.
Improve compliance through predictive analytics.
AI-Assisted decision-making automations for diagnosis and procedure codes.
Ability to work with physicians, IT professionals, SMEs, and medical coders.
Solutions to automatically recognize and extract data from medical records to facilitate auditing.
Workflows Optimization.
Conducting UAT and providing feedback to the respective teams.
Retraining and evaluating the performance of the automated model.
Estimating or projecting the return on investment (ROI).
Perform analysis of benchmarking.

Additional Roles and Responsibilities:

Lead Assistant Manager

EXL is hiring IPDRG - Lead Assistant Manager