Lead - Healthcare - Coding Quality Auditor

Job Title:

Lead - Healthcare - Coding Quality Auditor

Location*

Chennai, Tamil Nadu, India

Company Description

About Sutherland

Artificial Intelligence. Automation. Cloud engineering. Advanced analytics. For business leaders, these are key factors of success. For us, theyre our core expertise.
We work with iconic brands worldwide. We bring them a unique value proposition through market-leading technology and business process excellence.

We’ve created over 200 unique inventions under several patents across AI and other critical technologies. Leveraging our advanced products and platforms, we drive digital transformation, optimize critical business operations, reinvent experiences, and pioneer new solutions, all provided through a seamless “as a service” model.

For each company, we provide new keys for their businesses, the people they work with, and the customers they serve. We tailor proven and rapid formulas, to fit their unique DNA. We bring together human expertise and artificial intelligence to develop digital chemistry. This unlocks new possibilities, transformative outcomes and enduring relationships.

Job Description:

• Determine and assign the principal and significant secondary ICD-10-CM diagnosis codes, in addition to present on admission indicators, and CPT procedure codes, using official coding guidelines and analytical skills.
• Knowledge of physician query profess and ability to write physician query in compliance with UHDDS regulations.
• Candidates should have strong written communication skills to provide effective feedback and coaching.
• Conduct daily feedback review with bottom coders and provide focused training to improve their scores.
• Conduct daily huddles and keep the team updated on coding clinics, and general guidelines.
• Prepare focus audit list based on internal and external audits, and proactively arrest the issues and improve quality.
• Perform daily audits on client data for completeness and accuracy of coding utilizing both coding and clinical background to ensure appropriateness for reimbursement.
• Respond to client logics and record reviews.
• Monitor acceptance rate for assigned clients and assist management in proactively detecting negative deviations.
• Works diligent to meet and exceeds quality benchmark.
• Take charge of ongoing learning and development and participates in relevant training and development activities.
• Maintains high degree of professional and ethical standards focuses on continuous improvement in quality.
• Minimum 3+years of experience in any one of the following specialties
• SPECIALITIES: E/M IP and OP - Edits and Denials. Should have exposure in Athena one application
• Any graduate (Preferable life science graduate)
• Strong domain skills in ED professional and facility
• Effective verbal and written communication skills.