DRG Reviewer

Zelis • hyderabad, telangana, India • Posted June 17, 2026

Location hyderabad, telangana

Job Type Full-time

Category Other-General

Posted June 17, 2026

Position Overview 
The Inpatient DRG Reviewer will be primarily responsible for conducting post-service, pre-payment and post pay comprehensive inpatient DRG reviews based on industry standard inpatient coding guidelines and rules, evidence based clinical criteria plan, and policy exclusions. Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10 Official Coding Guidelines, AHA Coding Clinic 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 in DRG. The ideal candidates should have: 
Key Responsibilities:  
Perform comprehensive inpatient DRG validation reviews to determine accuracy of the DRG billed, based on industry standard coding guidelines and the clinical evidence supplied...
            

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