Hiring for Profee Surgery QA - Hyderabad

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

Job summary

Eclat-Health-Solutions-4 is looking for a Profee Surgery Quality Analyst in Hyderabad. The successful candidate will be responsible for auditing coded medical records to ensure accuracy and compliance with regulatory standards. This role requires a minimum of 5 years of medical coding experience with certification, along with expertise in Profee surgery coding guidelines.

The Quality Analyst will monitor coding quality metrics, provide training, and assist in resolving coding denials when necessary. This position is office-based with an emphasis on auditing multiple specialties.

.

Qualifications

• Minimum of 5 years of medical coding experience.
• Certification in medical coding is mandatory.
• Experience in auditing Profee surgery settings.

Responsibilities

• Audit coded medical records for Profee Surgery speciality.
• Provide training to coding teams based on audit findings.
• Monitor coding quality benchmarks.

Skills

Expertise in Profee surgery coding guidelines

Knowledge of CPT codes

Knowledge of ICD-10-CM

Experience in auditing multiple specialties

Feedback and coaching abilities

Education

Certification in Medical Coding

Tools

Coding software

Encoder tools

EHR systems

Job description

Hiring for Profee Surgery QA - Hyderabad

5 - 7 Years

Full-Time

Job SummaryThe Quality Analyst is responsible for auditing coded medical records with a primary focus on Profee Surgery speciality to ensure coding accuracy, compliance with regulatory standards, and adherence to payer guidelines. The role involves reviewing Surgery medical records across multiple specialties and validating correct code assignment within the 10000 to 60000 CPT sections using the Current Procedural Terminology (CPT), ICD-10-CM, Modifiers and HCPCS Level II code sets. The Quality Analyst will identify coding discrepancies, provide feedback and training to coding teams, monitor quality metrics, and ensure compliance with payer policies and regulatory guidelines.

Key Responsibilities

• Expertise: In-depth knowledge of Profee surgery coding guidelines, CPT, ICD-10-CM, HCPCS Level II codes & Modifiers.
• In-depth knowledge in auditing multiple specialties such as Orthopaedics, Family practice, OBGYN, Neurology, Oncology, Gastrointestinal etc.
  • Validate and ensure the correct assignment of CPT, ICD-10-CM, HCPCS Level II codes & Modifiers.
  • Identify coding errors, documentation gaps, and compliance risks.
  • Monitor coding quality benchmarks and maintain audit accuracy standards.
  • Provide feedback, coaching, and training to coding teams based on audit findings.
  • Support coding accuracy improvement initiatives and process optimization.
  • Stay updated with coding guideline updates, payer policies, and regulatory changes.
  • Utilize coding software, encoder tools, and electronic health record (EHR) systems to ensure accurate charge capture and documentation.
  • Meet established audit productivity and quality standards.
  • Assist in resolving coding denials and appeals when required.

Required Skills

• Minimum 5+ years of medical coding experience
• Certification Mandatory
• Experience in auditing Profee surgery settings.
• Knowledge of multiple specialty coding as outlined.

Preferred Experience

• Prior experience working as Quality Analyst (QA) or Coding Audit roles

Familiarity with coding audit tools, encoder software, and EHR systems

Open Positions : QA

Eligibility for QA - Min 5 years

Work Mode: Work from office