ED Profee Coders/QA

ECLAT Health Solutions; Mumbai; On-site; INR 600,000 - 900,000; Full time

Job summary

ECLAT Health Solutions is seeking an ED Profee Medical Coder to review and assign CPT, ICD-10-CM, HCPCS, and E/M codes for Emergency Department encounters. You will ensure compliance with CMS, payer regulations, and coding standards while meeting productivity and quality targets.

Responsibilities include abstracting clinical information, querying for clarification, and staying updated on coding changes. Requires CPC or CCS, and at least 1 year of ED coding experience.

Qualifications

• Must hold CPC from AAPC or CCS from AHIMA.
• Minimum 1+ year of ED Profee coding experience.
• Strong knowledge of Emergency Medicine coding, E/M guidelines, CPT/ICD-10-CM/HCPCS.

Responsibilities

• Review ED physician documentation and assign CPT, ICD-10-CM, HCPCS, and E/M levels.
• Ensure coding accuracy and CMS/AMA guidelines compliance.
• Abstract clinical data and apply correct coding principles.
• Query providers when documentation is unclear or incomplete.
• Identify opportunities for documentation improvement.
• Maintain productivity and quality benchmarks.
• Participate in coding audits and stay updated on changes.

Skills

Analytical skills

Communication skills

EMR/EHR proficiency

Medical terminology

Attention to detail

Tools

Encoder tools

EMR/EHR systems

Job description

The ED Profee Medical Coder is responsible for reviewing, analyzing, and assigning accurate CPT, ICD-10-CM, HCPCS, and E&M codes for Emergency Department professional fee encounters. The coder ensures compliance with client requirements, payer regulations, CMS guidelines, and coding standards while maintaining productivity and quality targets.

Key Responsibilities

• Review Emergency Department physician documentation and assign appropriate:
  • CPT codes
  • ICD-10-CM diagnosis codes
  • HCPCS codes
  • E&M levels based on documentation
• Ensure coding accuracy and compliance with CMS, AMA, CPT, and coding guidelines.
• Abstract clinical information from medical records and apply correct coding principles.
• Query providers when documentation is incomplete or unclear.
• Identify coding opportunities and documentation improvement areas.
• Meet established productivity and quality benchmarks.
• Participate in internal and external coding audits.
• Stay updated with coding changes, payer regulations, and industry best practices.
• Maintain confidentiality and HIPAA compliance.

Required Qualifications

• Certified Professional Coder (CPC) from AAPC or Certified Coding Specialist (CCS) from AHIMA.
• Minimum 1+ years of ED Profee coding experience.
• Strong knowledge of:
  • Emergency Medicine coding
  • E&M guidelines
  • CPT, ICD-10-CM, and HCPCS coding systems
  • Medical terminology, anatomy, and physiology
• Experience working with EMR/EHR systems and encoder tools.
• Strong analytical and communication skills.

Preferred Qualifications

• Experience with Leveling Guidelines for Emergency Department encounters.
• Familiarity with US healthcare payer regulations and reimbursement methodologies.
• Experience in coding audits and quality assurance processes.