Auditor

Coronis Ajuba; Chennai; Hybrid; INR 600,000 - 1,200,000; Full time

Job summary

Coronis Ajuba in Chennai is seeking an experienced Senior Executive/Team Lead – Quality Auditor for E&M and Surgery LI auditing. You will review medical records, validate coding accuracy, and ensure compliance with payer and client guidelines.

Strong feedback delivery and ongoing quality improvement will be essential. Candidates should have 3–8 years in medical coding auditing, CPC certification (preferred), and proficiency in CPT/ICD-10-CM, HCPCS, NCCI, and LCD/NCD guidelines.

Qualifications

• Graduate with Medical Coding Certification (CPC preferred).
• 3–8 years of experience in Medical Coding auditing.
• Mandatory CPC certification.

Responsibilities

• Audit E&M (office, hospital, consultations, observation) coding accuracy.
• Audit Surgical coding: CPT, ICD-10-CM, HCPCS, modifiers usage.
• Review LOS assignment per E&M guidelines.
• Identify undercoding/overcoding and compliance risks.
• Provide audit feedback and coaching to coders.

Skills

E&M Coding

Surgery Coding

CPT/ICD-10-CM

Auditing

Communication

Education

Medical Coding Certification (CPC preferred)

Tools

CPT/ICD-10-CM guidelines

NCCI Edits

Job description

Work Mode: Chennai (Work from Office / Hybrid as per business need)

About the Role

Job Description: Medical Coding – E&M & Surgery LI Auditor

Designation: Senior Executive / Team Lead – Quality Auditor (E&M & Surgery)

Job Summary

• We are seeking an experienced E&M and Surgery LI Auditor to review, audit, and ensure the accuracy of medical coding for Evaluation & Management (E&M) and Surgical specialties.
• The candidate will be responsible for validating coding accuracy, ensuring compliance with payer and client guidelines, identifying coding opportunities, and providing feedback to coding teams.

Responsibilities

• Audit E&M (Office, Hospital, Consultations, Observation) medical records for coding accuracy.
• Perform audits on Surgical coding including CPT, ICD-10-CM, HCPCS, and modifier usage.
• Review Level of Service (LOS) assignment as per current E&M documentation guidelines.
• Identify undercoding, overcoding, and compliance risks.
• Ensure adherence to CMS, AMA, payer-specific, and client requirements.
• Provide audit feedback, error analysis, and coaching to coders.
• Track and publish audit quality reports and trends.
• Participate in calibration sessions and quality improvement initiatives.
• Support internal and external compliance audits.

Qualifications

• Qualification: Any Graduate with Medical Coding Certification (CPC preferred)

Required Skills

• Strong knowledge of E&M Coding Guidelines (2021 onwards).
• Expertise in Surgery Coding across multiple specialties.
• Proficient in CPT, ICD-10-CM, HCPCS, Modifiers, NCCI Edits, LCD/NCD guidelines.
• Experience in auditing professional fee coding.
• Ability to analyze medical records and physician documentation.
• Excellent communication and feedback delivery skills.

Preferred Skills

• Experience with US Healthcare RCM and coding compliance.
• Additional certifications such as COC, CIC, CPMA preferred.

Pay range and compensation package

Not specified.

Equal Opportunity Statement

Not specified.

• 3-8 years of experience in Medical Coding.
• Minimum 2+ years of experience in E&M and Surgery Auditing.
• Certified Professional Coder (CPC) mandatory.
• Additional certifications such as COC, CIC, CPMA preferred.
• Experience with US Healthcare RCM and coding compliance.

Preferred Specialties

• General Surgery
• Orthopedic Surgery
• Cardiovascular Surgery
• ENT
• Urology

Key Performance Indicators (KPIs)

• Productivity as per client benchmark
• Timely completion of audit reports and feedback

Shift

• General Shift / Flexible based on client requirements