Analyst - Quality

INFINX; Hyderabad, Navi Mumbai; On-site; INR 600,000 - 900,000; Full time

Job summary

INFINX in Hyderabad, India is seeking a Medical Coding Quality Analyst to audit coding accuracy, ensure compliance, and support process improvements across the revenue cycle. The role requires strong analytical skills, attention to detail, and the ability to coach coders.

You will monitor quality scores, provide feedback, and stay current with ICD-10-CM, CPT, and HCPCS guidelines to drive quality outcomes. Collaboration with operations and clients, calibration sessions on audits, and development

Qualifications

• Graduate in Life Sciences, Nursing, Pharmacy, or related healthcare field.
• Certification such as CPC, CCS, CIC, CRC, or equivalent preferred.
• 2-5 years of medical coding experience with at least 1 year in quality auditing or mentoring.
• Strong knowledge of ICD-10-CM, CPT, HCPCS, and medical terminology.
• Familiarity with anatomy, physiology, disease processes, and healthcare documentation.

Responsibilities

• Conduct quality audits of medical records coded using ICD-10-CM, CPT, HCPCS, and other applicable coding systems.
• Evaluate coding accuracy, completeness, and compliance with client and regulatory requirements.
• Identify coding errors, documentation gaps, and compliance risks.
• Provide constructive feedback and coaching to coders for performance improvement.
• Maintain and report coding quality scores, audit findings, and productivity metrics.
• Monitor adherence to coding guidelines, payer regulations, and organizational policies.
• Perform root cause analysis of recurring coding errors and recommend corrective actions.
• Participate in calibration sessions with operations and clients to ensure audit consistency.
• Support training initiatives and assist in developing educational materials.
• Prepare quality reports, dashboards, and presentations for management review.
• Stay updated with coding guideline changes, payer updates, and industry standards.

Skills

Analytical skills

Auditing

Attention to detail

Coaching skills

Regulatory knowledge

MS Excel

Quality tools

Independent worker

Education

Life Sciences

Nursing

Pharmacy

Tools

MS Excel

Reporting tools

Quality Mgmt Systems

Job description

Analyst - Quality:

Job Title

Medical Coding Quality Analyst

Job Summary

The Medical Coding Quality Analyst is responsible for auditing medical coding activities to ensure accuracy, compliance, and adherence to coding guidelines. The role involves reviewing coded medical records, identifying coding errors, providing feedback to coders, analyzing quality trends, and supporting continuous process improvement initiatives.

Key Responsibilities

• Conduct quality audits of medical records coded using ICD-10-CM, CPT, HCPCS, and other applicable coding systems.
• Evaluate coding accuracy, completeness, and compliance with client and regulatory requirements.
• Identify coding errors, documentation gaps, and compliance risks.
• Provide constructive feedback and coaching to coders for performance improvement.
• Maintain and report coding quality scores, audit findings, and productivity metrics.
• Monitor adherence to coding guidelines, payer regulations, and organizational policies.
• Perform root cause analysis of recurring coding errors and recommend corrective actions.
• Participate in calibration sessions with operations and clients to ensure audit consistency.
• Support training initiatives and assist in developing educational materials.
• Prepare quality reports, dashboards, and presentations for management review.
• Stay updated with coding guideline changes, payer updates, and industry standards.

Required Qualifications

• Graduate in Life Sciences, Nursing, Pharmacy, or related healthcare field.
• Certification such as CPC, CCS, CIC, CRC, or equivalent preferred.
• 2-5 years of medical coding experience with at least 1 year in quality auditing or mentoring.
• Strong knowledge of ICD-10-CM, CPT, HCPCS, and medical terminology.
• Familiarity with anatomy, physiology, disease processes, and healthcare documentation.

Required Skills

• Strong analytical and auditing skills.
• Excellent attention to detail and accuracy.
• Effective communication and coaching abilities.
• Knowledge of healthcare compliance and regulatory requirements.
• Proficiency in MS Excel, reporting tools, and quality management systems.
• Ability to work independently and manage multiple priorities.

Key Performance Indicators (KPIs)

• Coding accuracy percentage.
• Audit completion and turnaround time.
• Reduction in coding error rates.
• Compliance adherence scores.
• Training and coaching effectiveness.
• Client satisfaction and quality outcomes.

Preferred Experience

• Experience in specialty coding such as Radiology, Surgery, E & M, ED, HCC, or Risk Adjustment.
• Exposure to client-facing quality reviews and process improvement projects.
• Experience with healthcare revenue cycle management and medical records systems.