E/M (OP & IP) - SME/TL

ECLAT Health Solutions; Hyderabad; On-site; INR 1,200,000 - 1,800,000; Full time

Job summary

Eclat-Health-Solutions-4 is seeking an experienced E/M Coding Subject Matter Expert in Hyderabad, India. The candidate will ensure compliance, accuracy, and consistency in outpatient and inpatient E/M coding across multiple specialties including podiatry, pediatrics, and orthopedics.

The role involves mentoring coding teams, conducting audits, and reviewing documentation. Candidates should possess CPC, CCS, CIC, or COC certification and have over 8 years of experience in E/M coding. Strong knowledge of coding guidelines and payer rules is essential.

Qualifications

• 8+ years of experience in E/M coding across multiple specialties.
• Expertise in coding nuances for podiatry, pediatrics, psychiatry, and surgery.
• Prior experience as a trainer or SME in coding operations preferred.

Responsibilities

• Act as the primary SME for multispecialty E/M coding.
• Review and validate E/M levels using AMA Guidelines.
• Mentor and support coding teams on complex E/M cases.
• Stay updated with coding standards and payer policy changes.

Skills

Expertise in outpatient and inpatient E/M coding

Knowledge of AMA E/M Guidelines

Familiarity with CPT, ICD-10-CM, and HCPCS

Previous experience mentoring or auditing

Education

CPC, CCS, CIC, or COC certification

Job description

Job Summary:

We are seeking an experienced E/M Coding Subject Matter Expert (SME) with strong expertise in outpatient and inpatient E/M coding across multiple specialties, including podiatry, pediatrics, psychiatry, orthopedics, and surgery. The SME will act as the coding authority, ensuring compliance, accuracy, and consistency with official guidelines while mentoring and supporting coding teams.

Key Responsibilities:

• Act as the primary SME for multispecialty E/M coding (OP & IP).
• Review and validate E/M levels using AMA Guidelines, MDM, and payor specifications.
• Provide specialty‑specific expertise (Primary medicine, podiatry, pediatrics, psychiatry, surgery, Orthopedics, etc.).
• Conduct audits, root cause analysis, and compliance reviews to maintain coding accuracy.
• Mentor, train, and support coders and auditors on complex E/M cases.
• Collaborate with providers to resolve documentation issues and improve accuracy.
• Support denial prevention and appeals with clear coding justifications.
• Stay updated with AHA Coding Clinic, CPT Assistant, CMS updates, and payer policy changes.
• Create best practices, SOPs, and training modules for E/M coding.

Qualifications & Skills:

• Certification: CPC, CCS, CIC, or COC required (additional specialty certifications a plus).
• Experience: 8+ years of inpatient and outpatient E/M coding with exposure to multiple specialties.
• In‑depth knowledge of AMA E/M Guidelines and IP E/M coding (Initial, Subsequent, Critical Care, Consults, Discharge services).
• Strong expertise in Specialty EM’s podiatry, pediatrics, psychiatry, and surgery documentation and coding nuances.
• Excellent understanding of ICD‑10‑CM, CPT, HCPCS, modifiers, and payer rules.
• Prior experience as trainer, auditor, or SME in coding operations preferred.