E&M - OP/IP- SME/TL/AM

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

Job summary

Eclat-Health-Solutions-4 is seeking an experienced E/M Coding Subject Matter Expert (SME) specializing in outpatient and inpatient coding across podiatry, pediatrics, psychiatry, orthopedics, and surgery. The role involves acting as the coding authority, ensuring compliance and accuracy while mentoring coding teams.

The right candidate should possess 8+ years of relevant experience, strong coding knowledge, and required certifications. Responsibilities include auditing, training, and supporting coding operations to maintain high coding standards.

Qualifications

• 8+ years of inpatient and outpatient E/M coding experience.
• In-depth knowledge of AMA E/M Guidelines.
• Expertise in documentation and coding for multiple specialties.

Responsibilities

• Act as the primary SME for multispecialty E/M coding.
• Conduct audits and compliance reviews.
• Mentor and support coders and auditors.

Skills

E/M coding expertise

Strong understanding of ICD-10-CM

Excellent understanding of CPT and HCPCS

Education

Certification: CPC, CCS, CIC, or COC

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.