Posted:2 weeks ago|
Platform:
On-site
Full Time
About the Role: Globe Centrix is seeking a detail-oriented and experienced Medical Coder Quality Analyst to support our healthcare compliance and revenue cycle integrity through comprehensive coding audits and quality assessments. This role plays a crucial part in ensuring that all coded data aligns with clinical documentation, payer guidelines, and industry standards. The ideal candidate will have a strong background in medical coding, a keen eye for accuracy, and a proactive approach to identifying and resolving discrepancies. If you're passionate about coding compliance, continuous improvement, and contributing to operational excellence, we’d love to hear from you. IMPORTANT AND MANDATORY SKILLS: Interested candidates must have excellent verbal and written communication skills in dealing with customers in the USA. The candidate must have the ability to work according to the time zones in the USA. Key Responsibilities: Conduct internal audits of coded medical records to assess accuracy, completeness, and compliance. Analyze trends in coding errors and provide constructive feedback to coders and clinicians. Ensure adherence to current coding guidelines (ICD-10-CM, CPT, HCPCS) and regulatory requirements (CMS, HIPAA, etc.). Develop and maintain documentation and reports on audit findings and quality metrics. Collaborate with the coding, billing, and compliance teams to ensure process integrity and performance consistency. Assist in the development and implementation of training programs to enhance coding quality. Stay updated with changes in coding regulations and payer requirements. Certification in medical coding (e.g., CPC, CCS, CPMA, RHIT, RHIA). 3+ years of medical coding experience, preferably with audit or quality assurance responsibilities. Strong understanding of medical terminology, anatomy, and physiology. Proficiency in coding tools, EHR/EMR systems, and Microsoft Office Suite. Excellent analytical, problem-solving, and communication skills. Ability to handle sensitive information with a high level of confidentiality and professionalism. CPMA (Certified Professional Medical Auditor) is highly desirable. Experience in both inpatient and outpatient coding environments. Familiarity with risk adjustment models (e.g., HCC coding). Required Skills: Proficiency in ICD-10-CM, CPT, and HCPCS Level II coding systems. Strong knowledge of medical terminology, anatomy & physiology, and clinical procedures. Familiarity with DRG and HCC coding (if applicable to the role). Experience using EHR/EMR systems (e.g., Epic, Cerner, Meditech). Understanding of coding edits and claim rejection reasons (e.g., NCCI, LCD/NCD policies). Experience conducting coding quality audits (prospective and/or retrospective). Knowledge of CMS, HIPAA, and OIG compliance guidelines. Ability to identify undercoding, overcoding, and documentation discrepancies. Skilled in root cause analysis and making data-driven recommendations. Clear and professional written and verbal communication for feedback and reporting. High level of attention to detail and accuracy. Strong analytical thinking to interpret coding patterns and trends. Ability to assess documentation for completeness and compliance with payer requirements. Proficient in Microsoft Office Suite (Excel, Word, PowerPoint). Capable of maintaining detailed audit logs, reports, and action plans. Strong time management skills with the ability to manage multiple audits and deadlines.Ability to provide constructive feedback to coders and clinicians. Experience in creating or delivering training sessions or educational resources. Team player with the ability to work across departments (coding, billing, compliance). Professionalism in handling confidential information. Flexible and adaptable to changes in coding standards or healthcare regulations. Qualifications: Education: Bachelor’s degree in a relevant field. Experience: A minimum of 5 years of experience as a Medical Coder, including at least 2 years of documented experience in a Quality Analyst role. Preferred: Prior experience in cardiovascular coding is highly desirable. Benefits and Perks Transportation cab service to return home Transportation bonus (if using a personal vehicle) Attendance bonus Yearly bonus Why Join Us: Opportunity to work with a dynamic team of professionals and achieve growth and expertise in your chosen field. Competitive salary, bonuses, and comprehensive benefits package. Ready to take your design and development game to the next level? Join us! Show more Show less
Globe Centrix
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My Connections Globe Centrix
Kolkata, West Bengal, India
Salary: Not disclosed
Kolkata, West Bengal, India
Salary: Not disclosed