E/M Medical Coder, Optum, Chennai

Optum; Chennai District; On-site; INR 3,00,000 - 5,00,000; Full time

Job summary

A leading healthcare service provider is seeking a Medical Coder in Chennai, Tamil Nadu. The role involves multispecialty coding for outpatient clinics and adherence to coding guidelines. Candidates should have a background in Life Sciences or Allied Medicine and experience in coding procedures. Strong knowledge of Medical Terminology and compliance with regulatory guidelines is essential.

Qualifications

• Minimum 0.6 to 2.6 years in multispecialty Evaluation & Management medical coding.
• Hands-on experience in coding multispecialty services.
• Expertise in determining EM levels based on MDM.

Responsibilities

• Verifies and abstracts data from medical records to assign codes.
• Codes 12 charts per hour, meeting quality standards.
• Tracks updates of AMA, AHA, and CMS guidelines.

Skills

Medical Terminology

Human Anatomy & Physiology

ICD-10-CM guidelines

CPT coding

HCPCS guidelines

Education

Life Science or Allied Medicine Graduates with certification from AAPC or AHIMA

Job description

JOB DESCRIPTION

EXPERIENCE: Minimum 0.6 to 2.6 years in multispecialty Evaluation & Management medical coding.

EDUCATIONAL QUALIFICATION: Life Science or Allied Medicine Graduates with certification from AAPC or AHIMA.

PROFESSIONAL QUALIFICATION

• Hands‑on experience in coding multispecialty Evaluation & Management services such as Internal Medicine, Family Medicine, Urgent Care, Dermatology, Gastroenterology, Cardiology, Otolaryngology, etc.
• Sound knowledge in Medical Terminology, Human Anatomy & Physiology.
• Proficient in ICD‑10‑CM, CPT, and HCPCS guidelines.

ROLES AND RESPONSIBILITIES

• Verifies and abstracts all the relevant data from the medical records to assign appropriate codes for outpatient clinics, urgent care centres, and inpatient hospital settings.
• Ability to code 12 charts per hour and meet the standards for quality criteria.
• Constantly tracks and implements all updates of AMA, AHA, and CMS guidelines.
• Expertise in determining the EM levels (99202‑99215) based on MDM and appending modifiers to CPT codes as per NCCI edits and CPT guidelines.
• Reviews and analyzes medical records and adds/modifies CPT codes for minor surgical procedures, vaccines, and laboratory CPT codes as per documentation.
• Extracts and codes various screening CPT codes and PQRS codes from the documentation.
• Checks NCCI edits and LCD & NCD coverage determinations and modifies ICD‑10‑CM codes, CPT codes, and modifiers accordingly.
• Collaboration as a team player, providing inputs to improve quality and productivity.
• Under general supervision, organizes and prioritizes all work to ensure compliance with regulatory and client guidelines within required timeframes.
• Adheres to confidentiality, maintains system security, and complies with HIPAA policies and procedures for patient records.
• Demonstrates knowledge of system security and associated policies and procedures for protecting data.