EM SME

ECLAT Health Solutions; Hyderabad; On-site; INR 1,200,000 - 2,400,000; Full time

Job summary

ECLAT Health Solutions in Hyderabad seeks an experienced E/M Coding SME to lead multispecialty coding for outpatient and inpatient settings. You will mentor teams, validate E/M levels, and stay aligned with AMA guidelines and payer rules.

The role requires expert knowledge across podiatry, pediatrics, psychiatry, orthopedics, and surgery, with a focus on accuracy, compliance, and documentation improvements. Training and audits are key facets.

Qualifications

• 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, Subtotal? Subsequent, Critical Care, Consults, Discharge services).
• Strong expertise in podiatry, pediatrics, psychiatry, orthopedics, 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.

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 to support coding accuracy.
• 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.

Skills

CPC certification

CCS certification

CIC certification

COC certification

EM coding expertise

Education

CPC certification

CCS certification

CIC certification

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 Speciality 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.