Experienced Pathology Coder

2 - 7 years

4 - 9 Lacs

Posted:1 day ago| Platform: Naukri logo

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Job Type

Full Time

Job Description

Graduate in Life Sciences (e g, Nursing, Pharma, Biochemistry, Microbiology) Minimum 2 years of experience in pathology coding, preferably with MIPS/QPP exposure Strong understanding of CPT, ICD-10-CM, and modifier usage in pathology Familiarity with MUEs, QPP measures, and CMS coding guidelines Review pathology accessions for MIPS-related coding requirements.
  • Assign CPT, ICD-10, and appropriate modifiers based on documentation and QPP measure criteria.
  • Collaborate with offshore coding teams to review impacted accessions and provide feedback.
  • Validate MUE (Medically Unlikely Edits) logic and apply appropriate code substitutions (e g, 88307 x8 + 88305 x2).
  • Identify and triage failed accessions for QA review and potential recoding or addendum.
  • Ensure accurate classification of accessions as Pass, Fail, Exclude, or Exempt.
  • Participate in monthly dashboard reviews and support CAP/MRO submission processes.
  • Maintain compliance with CMS, CAP, and NHPMG coding standards.
  • Support reconciliation of coded volumes and ensure reporting accuracy
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