Quality Analyst, Medical Coding

Location

Chennai | India

Job description

Description

Job Purpose

Multi-specialty certified professional coder with knowledge of inpatient and outpatient coding and auditing for various specialties, with preparation and presentation of audit results.

Duties and Responsibilities

• Perform coding audits and compliance audits for providers, including physicians and mid-level providers. Prepare reports of audits and present audits to internal and external parties as needed
• Complete accurate application of appropriate coding and documentation guidelines, including but not limited to, E&M and surgery documentation guidelines, CCI guidelines, CPT/HCPCS coding guidelines, and specialty association guidance
• Complete coding audits for our copartners' coding WQ
• Work with any offsite auditors
• Evaluate and report on the overall quality of physician documentation that supports selected codes most specifically but not inclusive of medical necessity
• Adhere to local and national coverage determinations, and CCI and payer specific editing rules
• Ensure appropriate documentation and coding of split/shared services, teaching physician guidelines and any client specific quality assessment programs
• Compile, trend, analyze and report on all findings that do not meet all of the guidelines listed above
• Use, protect and disclose patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
• Maintain a professional attitude
• Other duties as assigned by the management team

Requirements

Qualifications

• CPC or CCS coding certification required from AHIMA or AAPC
• High School graduate or equivalent
• Minimum 1 years of coding and/or auditing experience
• Knowledge of Microsoft Word, Outlook, Excel
• Must be able to use job-related software

Working Conditions

General Office Environment

• While performing the duties of this job, the employee is occasionally required to move around the work area
• Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear
• The employee must be able to follow directions, to get along with others, and handle stress
• The noise level in the work environment is usually minimal

Job tags

Salary