Work from Office
Full Time
ROLES & RESPONSIBILTIES
• Review pathology accessions for MIPS-related coding requirements.
• 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
QUALIFICATIONS:
SKILLS & COMPETENCIES:
• In-depth knowledge of pathology terminology, procedures, and documentation
• Strong analytical and abstraction skills
• Experience working with coding platforms (e.g., XiFin, SFTP workflows)
• Excellent communication skills for collaboration with offshore teams and internal stakeholders • Proficiency in Excel and reporting tools (preferred)
• Ability to work independently and manage timelines effectivel
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