Medintelx Healthcare Services Pvt Ltd DRG Auditing & AI Solutions

Role & Responsibilities Review and analyze provider documentation for outpatient encounters , including office visits, urgent care, telehealth, and same-day procedures. Assign accurate and compliant CPT, HCPCS, and ICD-10-CM codes, with a focus on Evaluation and Management (E/M) services. Determine correct E/M levels based on official coding guidelines ( 1995, 1997, and 2021 E/M Guidelines ). Validate medical necessity and ensure documentation supports billed services. Abstract coded data and enter it accurately into the Electronic Health Record (EHR) or coding software system. Collaborate with providers, billing, and compliance teams to clarify documentation or resolve discrepancies. Participate in coding audits and assist in implementing corrective actions when needed. Stay updated on current coding regulations , payer policies, and organizational standards. Support the revenue cycle process by ensuring accurate and timely coding to minimize claim denials. Maintain strict confidentiality and HIPAA compliance at all times. Preferred Candidate Profile Education: Bachelor’s or Master’s degree in Health Information Management , Health Sciences , or a related field. Certifications (any one required): CPC® (Certified Professional Coder) – AAPC COC® (Certified Outpatient Coder) – AAPC CCA® (Certified Coding Associate) – AHIMA Experience: Minimum 2+ years of experience in outpatient coding , specifically E/M coding . Experience working with EHR systems such as Epic, Cerner, or Athenahealth preferred. Technical Skills: Strong knowledge of CPT®, HCPCS, and ICD-10-CM coding systems. Understanding of E/M documentation guidelines and payer requirements . Proficiency with coding software and Microsoft Office tools . Soft Skills: Excellent attention to detail and analytical thinking . Strong communication and team collaboration skills. Ability to work independently and maintain accuracy under pressure . Commitment to confidentiality , compliance , and continuous learning .