Quality Controller ( Coding )

Location

Chennai | India

Job description

Coding auditor provides education to coders based on audit findings; provides general education on ICD-10, CPT, HCPCS codes and modifiers as appropriate. Highlight/Escalate any major issues to the management.

Roles and Responsibilities:

• Performs coding compliance audits on E&M visits/encounters in all settings/sites (professional and technical), and/or CPT coded services performed by clinical institutes and/or physicians, using criteria based on official CPT and ICD-10 guidelines and other applicable regulations

• Performs inpatient coding audits using ICD-10-CM/PCS, DRG validation utilizing appropriate coding references for hospitals via scanned, electronic and hybrid medical records

• Performs centralized outpatient coding audits of scanned or copied medical records and abstracts using ICD-10-CM and CPT and appropriate coding references, for CHS hospitals and CCS coding staff

• Stays current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-10 coding

• Develop and conduct ongoing coding training to include but not limited to ICD-10-CM and Medicare Risk Adjustment coding to new associates, training for existing staff as needed

• Attend the Compliance Committee meetings

• Provide other services as needed to assist in effective operations of the compliance program

• Work with CHKS clients both in the NHS and private sector by undertaking regular complex audits of clinically coded data to assess coding quality for accuracy, completeness, consistency and timeliness

• To support clients in the development of audit programmes to ensure ongoing improvements in their quality assurance for both the organisation and their commissioners

• Have a pro-active and positive approach when working with clients to identify areas where further work may be required, for example training or more specialised audit

SKILLS REQUIRED (If any)

Skills

• Should have multispeciality coding and audit experience

• Knowledge in CDI will be an added advantage

• Medical coding certification through either AAPC or AHIMA: CPC/COC/CIC/CCS.

• Strong understanding of healthcare principles and concepts.

• Good at creating SOPs Process mapping.

• Strong Client interaction and Management Skills.

• Good Communication Skills, Analytical Skills and Interpersonal Skills

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