Medical Coding - QCA - Associate - GO/JC/4941/2026

Golden Opportunities; Chennai; On-site; INR 360,000 - 600,000; Full time

Job summary

Golden Opportunities in Chennai seeks a qualified QCA coder to perform quality audits of medical coding records and ensure accuracy across ICD-10-CM, CPT, and HCPCS. You will review denials, support corrections, and assist in training to improve productivity and compliance.

The role requires Life Science graduates with experience in QCA, denials, E/M, or surgery coding, and a solid grasp of payer guidelines.

Qualifications

• Bachelor's degree in Life Science required.
• Experience in QCA, Denials, E&M, or Surgery coding preferred.
• Strong knowledge of ICD-10-CM, CPT, HCPCS and payer guidelines.

Responsibilities

• Perform quality audits of medical coding records to ensure coding accuracy.
• Review ICD-10-CM, CPT, and HCPCS codes for compliance.
• Identify coding errors, provide feedback, and recommend corrective actions.
• Monitor coding accuracy, productivity, and quality metrics.
• Conduct root cause analysis and support coder training.
• Review medical coding-related claim denials and identify root causes.
• Analyze denials related to incorrect coding, modifiers, medical necessity, and documentation.
• Review EOBs, payer guidelines, and denial reason codes.
• Support claim corrections, appeals, and resubmissions.
• Work on denial prevention and improvement initiatives.
• Review and assign appropriate E&M codes based on provider documentation.
• Understand office visits, hospital visits, consultations, and emergency department coding.
• Apply appropriate medical decision-making (MDM) and time-based coding guidelines.
• Ensure accurate code selection as per current CPT guidelines.
• Review operative reports and assign appropriate CPT codes.
• Apply knowledge of surgical procedures, anatomy, and medical terminology.
• Ensure correct usage of modifiers and bundling/unbundling guidelines.
• Understand NCCI edits and global surgical package rules.
• Ensure coding compliance with payer and regulatory guidelines.

Skills

QCA coding

Denials

E/M coding

Surgery coding

ICD-10-CM

CPT

HCPCS

Coding compliance

Payer guidelines

Education

Bachelor's degree in Life Science

Job description

Candidate Expectations

• Total and Relevant Experience – 3 Years to 6 Years
• Candidate Location - Anywhere
• Skills – QCA, Denials, E&M, or Surgery coding
• Candidate Industry (Life science)
• Diversity – No

Job Title

QCA – Denials / EM / Surgery

Job Location

Chennai

Work Model

Work from office

Education and Certification

Qualification: Any Life Science Graduate

Specific Remarks: Distance education not accepted.

Certification

• CPC – Certified Professional Coder
• CCS – Certified Coding Specialist
• CIC – Certified Inpatient Coder
• Relevant medical coding certifications.

Detailed Job Description

QCA – Quality Coding Audit

• Perform quality audits of medical coding records to ensure coding accuracy.
• Review ICD-10-CM, CPT, and HCPCS codes for compliance.
• Identify coding errors, provide feedback, and recommend corrective actions.
• Monitor coding accuracy, productivity, and quality metrics.
• Conduct root cause analysis and support coder training.

Denials Management

• Review medical coding-related claim denials and identify root causes.
• Analyze denials related to incorrect coding, modifiers, medical necessity, and documentation.
• Review EOBs, payer guidelines, and denial reason codes.
• Support claim corrections, appeals, and resubmissions.
• Work on denial prevention and improvement initiatives.

E&M – Evaluation & Management

• Review and assign appropriate E&M codes based on provider documentation.
• Understand office visits, hospital visits, consultations, and emergency department coding.
• Apply appropriate medical decision-making (MDM) and time-based coding guidelines.
• Ensure accurate code selection as per current CPT guidelines.

Surgery Coding

• Review operative reports and assign appropriate CPT codes.
• Apply knowledge of surgical procedures, anatomy, and medical terminology.
• Ensure correct usage of modifiers and bundling/unbundling guidelines.
• Understand NCCI edits and global surgical package rules.
• Ensure coding compliance with payer and regulatory guidelines.

Key Skills

• Strong knowledge of ICD-10-CM, CPT, and HCPCS.
• Good understanding of medical terminology and anatomy.
• Knowledge of coding compliance and payer guidelines.
• Experience in QCA, Denials, E&M, or Surgery coding.
• Strong analytical and communication skills.
• Ability to meet quality and productivity targets.

Other Specific Remarks

Additional Requirements: Proper documents for entire career and PF Form 16 Mandatory