Medical Coder-ED Profee coders

Ascent Business Solutions; Hyderabad; On-site; INR 480,000 - 720,000; Full time

Job summary

Ascent Business Solutions in Hyderabad is seeking a dedicated Quality Auditor to oversee audits of Emergency Department medical records and ensure coding accuracy and compliance across client projects.

You will validate ICD-10-CM, CPT, and HCPCS codes, review E/M levels, and provide constructive feedback to coders. The role emphasizes adherence to SOPs, regulatory standards, and improving overall audit outcomes.

Responsibilities

• Conduct quality audits of Emergency Department medical records coded by ED coders.
• Validate the accuracy of ICD-10-CM diagnosis codes, CPT codes, and HCPCS codes, wherever applicable.
• Review E/M level selection based on medical decision-making (MDM), documentation, and applicable coding guidelines.
• Verify the accuracy of principal and secondary diagnoses, sequencing, modifiers, and other coding elements, as applicable.
• Ensure compliance with official coding guidelines, payer requirements, client-specific SOPs, and regulatory standards.
• Identify coding discrepancies, undercoding, overcoding, missed diagnoses, and documentation-related issues.
• Provide timely, constructive feedback to coders and explain the rationale behind identified errors.
• Track audit scores, error trends, coder performance, and recurring quality issues.
• Conduct root cause analysis and recommend corrective and preventive actions to improve coding accuracy.
• Support coder education, refresher training, calibration sessions, and process updates.
• Participate in internal and client quality calibration meetings to ensure consistency in audit outcomes.
• Maintain audit documentation, quality reports, and productivity records within defined timelines.
• Meet established quality, productivity, turnaround time, and compliance targets.

Job description

• Conduct quality audits of Emergency Department medical records coded by ED coders.
• Validate the accuracy of ICD-10-CM diagnosis codes, CPT codes, and HCPCS codes, wherever applicable.
• Review E/M level selection based on medical decision-making (MDM), documentation, and applicable coding guidelines.
• Verify the accuracy of principal and secondary diagnoses, sequencing, modifiers, and other coding elements, as applicable.
• Ensure compliance with official coding guidelines, payer requirements, client-specific SOPs, and regulatory standards.
• Identify coding discrepancies, undercoding, overcoding, missed diagnoses, and documentation-related issues.
• Provide timely, constructive feedback to coders and explain the rationale behind identified errors.
• Track audit scores, error trends, coder performance, and recurring quality issues.
• Conduct root cause analysis and recommend corrective and preventive actions to improve coding accuracy.
• Support coder education, refresher training, calibration sessions, and process updates.
• Participate in internal and client quality calibration meetings to ensure consistency in audit outcomes.
• Maintain audit documentation, quality reports, and productivity records within defined timelines.
• Meet established quality, productivity, turnaround time, and compliance targets.