Quality Auditor

Healthcare Operations Management

3 - 6 years

3 - 8 Lacs

Noida Delhi / NCR

Posted:2 days ago| Platform:

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Skills Required

Certified Hcc Medical Coding audit Hcc Coding Revenue Cycle Management US Healthcare ICD chart audit Auditor Ccs CRC HIPAA CPC RCM

Work Mode

Work from Office

Job Type

Full Time

Job Description

Job Title: Quality Auditor Medical Coding (HCC)

Experience Required:

Roles & Responsibilities

Review and audit coded medical charts to ensure accuracy, completeness, and compliance with
ICD-10 and CPT
guidelines.
Conduct
quality audits specifically for HCC-coded charts
, ensuring adherence to CMS risk adjustment coding requirements.
Identify documentation gaps, coding errors, and trends across
multi-specialty charts
(e.g., E/M, ED)
Work closely with the coding team to provide
constructive feedback and training
based on audit findings.
Maintain audit records and prepare
quality reports
reflecting coder performance and compliance issues.
Support the development of corrective and preventive action plans (CAPA) to address audit findings.
Assist in maintaining client-specific coding accuracy benchmarks, typically
96% or higher
, and support continuous improvement efforts.
Stay updated with
ICD-10, CPT, CMS, and payer-specific guidelines
, and ensure coders are updated on changes.

Requirements

Have
3 to 6 years of experience
in medical coding and/or chart auditing.
Have
hands-on experience in HCC coding
; experience with
multi-specialty coding
is also acceptable.
Possess strong expertise in
ICD-10-CM guidelines
and application across various specialties.
Certified in CPC, CRC, COC, or CCS
or equivalent
AAPC/AHIMA certification.
Have experience in
reviewing coded charts for quality
and providing performance feedback.
Are proficient in Microsoft Office tools (especially Excel and Word).
Maintain a high level of professional integrity, attention to detail, and a commitment to quality standards.

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