Medical EM OP QA / QC

3 - 8 years

4 - 9 Lacs

Posted:21 hours ago| Platform: Foundit logo

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Work Mode

On-site

Job Type

Full Time

Job Description

Medical EM (Evaluation and Management) OP (Outpatient) Quality Assurance (QA) / Quality Control (QC)

Key Responsibilities

  • Conduct rigorous

    QA/QC reviews

    of

    Evaluation and Management (E&M) and Outpatient (OP)

    medical coding.
  • Identify and analyze coding discrepancies, documentation deficiencies, and compliance risks specific to E&M and Outpatient services.
  • Provide precise and constructive

    feedback

    to coders to improve their accuracy and understanding of complex E&M rules.
  • Ensure all coding practices comply with official coding guidelines (e.g., CPT, ICD-10-CM), payer requirements, and industry standards.
  • Collaborate with coding teams and clinical documentation specialists to enhance

    documentation quality

    .
  • Participate in the development and implementation of

    quality improvement programs

    and training materials.
  • Track and report on

    coding accuracy rates

    and identified error trends.

Qualifications

  • Certification:

    Must be a

    certified professional coder

    with expertise in

    EM and Outpatient coding

    .
  • Experience:

    Proven experience in

    EM/Outpatient medical coding

    and/or

    auditing

    .

Skills

  • Exceptional attention to detail

    and strong analytical skills.
  • In-depth knowledge of E&M guidelines

    , CPT, and ICD-10-CM coding for outpatient services.
  • Ability to effectively interpret complex clinical documentation for accurate code assignment.
  • Excellent

    communication and interpersonal skills

    for providing feedback and collaborating across teams.
  • Proficiency in medical coding software and electronic health record (EHR) systems.

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