Same Day Surgery QA

Role & responsibilities

• Review and analyze medical records, operative notes, and physician documentation for Same Day Surgery cases.
• Assign accurate

  ICD-10-CM, CPT, and HCPCS codes

  based on clinical documentation.
• Code outpatient surgical procedures, diagnoses, complications, and comorbidities as applicable.
• Ensure accurate

  CPT coding, modifiers, bundling, and NCCI edits

  as per coding guidelines.
• Validate medical necessity and ensure diagnosis-to-procedure coding accuracy.
• Identify documentation gaps and raise physician queries when required.
• Follow

  AMA CPT, ICD-10-CM, CMS, and payer-specific coding guidelines

  .
• Perform quality checks to maintain coding accuracy and compliance.
• Meet defined

  productivity, quality, and turnaround-time (TAT)

  targets.
• Review and resolve coding-related errors, denials, and client queries.
• Stay updated with annual changes in

  ICD-10-CM, CPT, HCPCS, and payer guidelines

  .
• Maintain patient confidentiality and comply with HIPAA and organizational policies.

Preferred candidate profile

• Graduate in

  Life Sciences, Nursing, Pharmacy, Allied Health Sciences, or Medical-related fields

  .

• 13 years of experience

  in medical coding, preferably in

  Same Day Surgery / Outpatient / Ambulatory Surgery coding

  .
• Strong knowledge of

  ICD-10-CM, CPT, HCPCS, and modifiers

  .
• Good understanding of

  surgical procedures, anatomy, and medical terminology

  .
• Experience with

  Surgery/Outpatient coding

  and knowledge of NCCI edits and bundling guidelines.

• CPC, CCS, CCA, or equivalent medical coding certification

  is preferred.
• Good analytical and documentation-review skills.
• Ability to meet

  quality, productivity, and TAT targets

  .
• Good written and verbal communication skills.
• Willingness to work in

  US healthcare / night shifts

  if required.
• Candidates with experience in

  US healthcare RCM and medical coding

  will be preferred.

Contact : Neela HR - 6385073741 and drop your resumes.