About this role
• 3+years of experience after certification is must • Perform detailed quality audits of coded medical records to ensure accuracy, compliance, and adherence to official coding guidelines and payer-specific requirements. • Review and analyze clinical documentation for completeness and accuracy in assigning CPT, ICD-10-CM, and HCPCS codes. • Identify coding errors, trends, and areas for improvement; provide actionable feedback and recommendations to the coding team. • Collaborate with coding managers and training teams to support process improvement and coding education initiatives. • Stay current with updates to coding standards, payer regulations, and compliance requirements.
• Must be an expert • Team handling skill set • Working in Quality team is an added advantage. • Inventory management and planning • Motivate and guide team to achieve production and quality goal set • Follow project related protocols and instructions • Handling team clarification • To be proactive in handling team issues • Problem solving skill sets • Research on grey areas with solution • Capable of conducting team education and training • Skill sets to address client email and queries • Should have more analytical skill sets • Should be more innovative, energetic and positive thoughts • Having skill sets to motivate teams • Escalate issues, identify trends • All emails from Manager should be answered promptly without fail • Ensure compliance of entire team for HIPAA,OIG
Education - Bachelor’s Degree in Science or Nursing.
Certifications
One or more of the following mandatory certifications:
3+years of experience after certification is must
CCS – Certified Coding Specialist
CIC – Certified Inpatient Coder
CPC – Certified Professional Coder
Experience -
• 4 - 6 year of Coding with quality experience • Specialty worked: IVR – Mandatory (Must be dealt with complex level IVR coding, cardiovascular surgery and General surgery • 3+years of experience after certification is must • CPMA certification is added advantage. • Location –Chennai • QC experience
Minimum 1–2 years of experience in a Quality Analyst or Quality Auditing role.
Preferred Qualifications (Desirable Criteria)
Strong proficiency in Microsoft Excel, including trackers, analysis, and reporting.
Experience working in SLA-driven, high-compliance healthcare environments.