Quality Auditor Healthcare Operations Management

3.0 - 6.0 years

3 - 8 Lacs

Noida, Delhi / NCR

Work from Office

Job Title: Quality Auditor Medical Coding (HCC) Location: Office-Based Experience Required: 3–6 Years Employment Type: Full-Time Roles & Responsibilities Review and audit coded medical charts to ensure accuracy, completeness, and compliance with ICD-10 and CPT guidelines. Conduct quality audits specifically for HCC-coded charts , ensuring adherence to CMS risk adjustment coding requirements. Identify documentation gaps, coding errors, and trends across multi-specialty charts (e.g., E/M, ED) Work closely with the coding team to provide constructive feedback and training based on audit findings. Maintain audit records and prepare quality reports reflecting coder performance and compliance issues. Support the development of corrective and preventive action plans (CAPA) to address audit findings. Assist in maintaining client-specific coding accuracy benchmarks, typically 96% or higher , and support continuous improvement efforts. Stay updated with ICD-10, CPT, CMS, and payer-specific guidelines , and ensure coders are updated on changes. Requirements Only those candidates may apply who: Have 3 to 6 years of experience in medical coding and/or chart auditing. Have hands-on experience in HCC coding ; experience with multi-specialty coding is also acceptable. Possess strong expertise in ICD-10-CM guidelines and application across various specialties. Certified in CPC, CRC, COC, or CCS or equivalent AAPC/AHIMA certification. Have experience in reviewing coded charts for quality and providing performance feedback. Are proficient in Microsoft Office tools (especially Excel and Word). Maintain a high level of professional integrity, attention to detail, and a commitment to quality standards.

Posted 2 days ago

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