Quality Analyst – IP DRG Coding
Company
Guidehouse
Job ID
35906
Job Category
Coding Quality – Inpatient (IP)
Employment Type
Full-Time
Travel Requirement
None
Work Clearance
Not Required
Location
India
Date Posted
February 09, 2026
Role Overview
The Quality Analyst – IP DRG Coding is responsible for ensuring accuracy, compliance, and quality in inpatient coding processes through structured quality assurance activities. The role involves auditing medical records, validating coding assignments, monitoring production schedules, and supporting continuous improvement initiatives to enhance coding accuracy and regulatory compliance.
This position plays a critical role in maintaining coding quality standards, supporting reimbursement optimization, and ensuring adherence to healthcare coding guidelines and organizational policies.
Experience Required
Minimum 3+ years of experience in Inpatient (IP) DRG coding.
At least 1 year of experience in inpatient coding auditing or quality analysis.
Strong understanding of coding compliance, reimbursement systems, and regulatory requirements.
Educational Qualifications and Certifications
Bachelor’s degree in any discipline (mandatory).
Required certifications: CIC, CCS, or CPC.
Key Responsibilities
Plan, monitor, and evaluate daily quality assurance production to ensure performance targets and deadlines are achieved.
Review medical records to validate accuracy of primary and secondary diagnoses and procedure coding using ICD and CPT coding conventions.
Ensure proper sequencing of diagnoses and procedures in accordance with coding guidelines.
Verify accurate MS-DRG or APC assignment where applicable.
Abstract and compile data from medical records to support compliant reimbursement for hospital or professional services.
Evaluate complex coding scenarios involving incomplete or unclear documentation and recommend appropriate resolutions.
Respond to queries from quality staff and escalate issues to leadership when required.
Monitor sampling targets and maintain high accuracy standards.
Maintain up-to-date knowledge of coding regulations, reimbursement policies, and reporting requirements.
Document quality findings, identify risk areas, and support training and standardization initiatives.
Provide mentorship and guidance to coding professionals to improve performance and compliance.
Coordinate quality meetings and participate in project launch sessions to understand coding workflows.
Support continuous education initiatives for coding and QA teams.
Ensure adherence to ethical coding standards and industry guidelines.
Maintain strong knowledge of anatomy, physiology, medical terminology, disease processes, and surgical procedures for accurate code application.
Participate in quality improvement programs, focused audits, and special projects.
Technical Knowledge and Skills
Strong understanding of ICD-10-PCS, CPT, and DRG coding systems.
Knowledge of reimbursement methodologies and regulatory compliance standards.
Ability to review patient records and assign appropriate DRGs.
Experience collaborating with clinical teams to ensure accurate documentation.
Strong analytical, problem-solving, and decision-making skills.
Excellent verbal and written communication abilities.
Preferred Qualifications
Experience with Microsoft Excel, Word, and PowerPoint.
Exposure to quality improvement initiatives and coding audit processes.
Compensation and Benefits
The organization offers competitive compensation and a comprehensive benefits package designed to support professional growth and employee well-being within a collaborative and inclusive work environment.
Uttar Pradesh :
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China | Quarry Bay |Liaoning :
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Greece |North Island :
Auckland |New Zealand :
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Madrid |Cebu Province :
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Manila |Croatia :
Croatia |Zagreb :
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King Abdullah Economic City | Khulais | Jeddah | Riyadh | Rabigh | Najran |Kuala Lumpur :
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Kyiv |Lima Region :
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