Analyst - Quality

THL; Navi Mumbai; In loco; INR 600.000 - 900.000; Tempo pieno

Descrizione del lavoro

THL is seeking an experienced Radiology Medical Coding Auditor to join its quality assurance team in Navi Mumbai. You will conduct detailed audits of diagnostic radiology coding to ensure accuracy and adherence to guidelines, payer policies, and NCCI rules.

You will review CPT, ICD-10-CM/PCS (as applicable) and modifiers, identify error trends, and provide actionable feedback. The role includes mentoring coders and supporting audits and process improvements.

Competenze

• Certified coding credential required: CPC/CPC-H or CCS.
• 5–8 years of hands-on Radiology Medical Coding experience.
• Knowledge of CPT, ICD-10-CM/PCS and modifiers.

Mansioni

• Perform detailed audits of radiology diagnostic coding for accuracy and compliance.
• Review CPT, ICD-10-CM/PCS and modifiers related to Radiology services.
• Maintain quality benchmarks and audit volumes.
• Identify errors, trends, and root causes; report with improvements.
• Provide feedback, retraining, onboarding from a quality perspective.
• Stay current with CPT, ICD updates and payer guidelines.
• Assist audits and compliance initiatives; participate in calibration sessions.

Conoscenze

Radiology coding

Quality auditing

Audit reporting

Process improvement

Formazione

CPC/CPC-H

CCS

Descrizione del lavoro

3 - 10 Years

Permanent

Job Description

Key Responsibilities

Quality Auditing & Review

• Performdetailed audits of radiology coding (Diagnostic) to ensure accuracy andcompliance.
• ReviewCPT, ICD‑10‑CM, ICD‑10‑PCS (as applicable), and modifiers related toRadiology services.
• Ensureadherence to official coding guidelines, payer policies, National CorrectCoding Initiative (NCCI), and client‑specific rules.
• Maintainrequired quality benchmarks and audit volumes.

Error Identification & Reporting

• Identifycoding errors, trends, and root causes.
• Prepareaudit reports highlighting accuracy scores, error types, and improvementareas.
• Trackcoder performance metrics and quality scores.

Education & Feedback

• Provideconstructive feedback and corrective action guidance to coders.
• Conductretraining sessions and educational feedback based on error trends.
• Supportonboarding and mentoring of new coders from a quality perspective.

Compliance & Process Improvement

• Staycurrent with annual CPT, ICD‑10, CMS, and payer guideline updates.
• Assistin implementation of process improvements to enhance coding accuracy andefficiency.
• Supportinternal and external client audits and compliance initiatives.
• Participatein calibration sessions to ensure consistent audit outcomes.
• Professionaland/or Facility coding (based on project)
• Contrast,modifiers, bundling, and unbundling compliance

Required Qualifications

• CertifiedCoding credential (one or more required):
  • CPC/ CPC‑H
  • CCS
• Minimum5–8 years of hands‑on Radiology Medical Coding experience.

Job Snapshot

Updated Date

Job ID

Job_1567

Function

Archive (Do Not Use)

Location