E&M QA

Key Responsibilities :

Perform quality audits on E&M-coded charts (Professional or Facility).

Validate CPT, ICD-10, and Modifier assignments according to payer rules and CMS guidelines.

Identify and report coding errors, trends, and compliance issues.

Provide feedback and coaching to coding teams to improve accuracy and productivity.

Collaborate with Team Leads and Coding Managers to ensure consistent audit standards.

Maintain audit records, reports, and performance metrics.

Stay updated with industry guidelines (CPT, ICD-10, HCPCS, CMS, OIG) and client updates.

Support new coder onboarding through QA feedback and educational sessions.

Required Skills & Qualifications :

Certification : CPC, COC, or CCS required (AAPC / AHIMA).

Experience : Minimum 2–4 years of experience in E&M coding and QA.

Strong knowledge of CPT, ICD-10-CM, Modifiers, and Medical Terminology.

In-depth understanding of 2021 E&M Guidelines.

Excellent analytical and attention-to-detail skills.

Strong communication and feedback skills.

Ability to meet daily / weekly audit targets and turnaround times.

Preferred Skills :

Experience with EMR / EHR systems like Epic, Cerner, or Athena.

Knowledge of risk adjustment and HCC coding.

Exposure to client QA audits and internal compliance reviews.