ENM OP - Coder , ENM - QA

2 - 7 years

4 - 6 Lacs

Posted:1 month ago| Platform: Foundit logo

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Skills Required

E&M QA E&M OP Coder AAPC CMS E&M 3M Optum

Work Mode

On-site

Job Type

Full Time

Job Description

Key Responsibilities:

E&M OP Coder

  • Review physician documentation and code

    outpatient visits

    (office, ER, urgent care, etc.).
  • Assign accurate

    ICD-10-CM

    and

    CPT

    codes based on

    E&M guidelines

    .
  • Apply appropriate

    modifiers, MDM levels

    , and

    time-based coding

    when applicable.
  • Ensure compliance with

    CMS, AAPC, and payer-specific guidelines

    .
  • Maintain productivity and coding accuracy as per SLA.

E&M QA (Quality Analyst)

  • Audit coded charts across multiple outpatient specialties (Internal Med, Family Med, ED, etc.).
  • Identify coding variances, MDM level errors, and documentation gaps.
  • Provide structured

    feedback and coaching

    to coders for continuous improvement.
  • Stay current with

    CMS E&M updates

    and help align team standards.
  • Maintain quality reports and ensure coding standards compliance.

Qualifications:

  • Education:

    Graduate in Life Sciences, Paramedical, or Healthcare-related fields
  • Certification (Mandatory):

    CPC, COC, CCS-P (AAPC/AHIMA)
  • Experience:

  • Coders:

    13 years in E&M or outpatient specialty coding
  • QA:

    35+ years in E&M coding + minimum 12 years of auditing experience

Skills Required:

  • Strong knowledge of

    ICD-10-CM

    ,

    CPT

    ,

    E&M 2021 guidelines

  • Excellent understanding of

    Medical Decision Making (MDM)

    and

    time-based coding

  • Proficient with encoder tools (3M, Optum, etc.) and EMR systems (Epic, Athena, eClinicalWorks)
  • Familiar with

    NCCI edits

    , documentation integrity, and payer rules
  • Strong written communication and QA documentation/reporting skills (for QA role)

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