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ENM OP / Ed facility / Surgery - Coder, QA
ConfidentialChennai30+ days ago
Job descriptionPerform detailed audits on coded medical records to ensure accuracy and completeness. Identify coding errors, inconsistencies, and opportunities for improvement. Provide feedback and coaching to coding teams to enhance coding quality. Prepare QA reports and maintain documentation for compliance and audits. Monitor compliance with internal SLAs and external regulatory requirements. Education : Graduate in Life Sciences, Paramedical, or Healthcare-related fields. Certifications : CPC, CCS, COC, or equivalent medical coding certifications mandatory. QA certifications or training preferred. Experience : Minimum 1–5 years coding experience in ENM OP, ED facility, and surgical coding. QA experience in healthcare coding is an added advantage. Tools : Proficiency in EMR / EHR systems (Epic, Cerner, Meditech) and coding software (3M, TruCode, Optum Encoder). Skills : Strong knowledge of medical terminology, anatomy, and coding guidelines. Attention to detail and analytical mindset.
Key Responsibilities :
Medical Coding Responsibilities :
- Review clinical documentation and assign accurate codes for ENM OP visits , Emergency Department (ED) services , and Surgical procedures using ICD-10-CM, CPT, and HCPCS coding systems.
- Apply knowledge of CPT modifiers, NCCI edits, bundling, and payer-specific guidelines.
- Ensure compliance with CMS, AAPC, AHIMA, and other regulatory standards.
- Clarify documentation through provider queries when necessary.
- Collaborate with billing and clinical teams for smooth claim submission.
Quality Assurance (QA) Responsibilities :
Requirements :
Skills Required
Quality Assurance, Sla Management
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