QA - Medical Coding

Harris Computer; Mumbai; On-site; INR 900,000 - 1,500,000; Full time

Job summary

Harris Computer in Mumbai, India seeks an experienced ED coding auditor to ensure accurate ICD-10-CM, CPT, and HCPCS coding and to verify E/M levels using MDM guidelines. You will review CMS and AMA guidelines, provide actionable feedback, and collaborate with physicians and leadership to elevate coding quality.

Ideal candidates hold CPC/COC/CCS/CIC certifications, with a minimum of 3 years in Emergency Department coding, and strong knowledge of NCCI edits and payer requirements.

Qualifications

• Certification in Medical Coding: CPC, COC, CCS, CIC, or equivalent preferred.
• Minimum 3 years of Emergency Department coding experience.
• Strong understanding of ED workflows and MDM-based E/M guidelines.
• Experience with ICD-10-CM, CPT, HCPCS coding systems and payer rules.

Responsibilities

• Perform quality audits of ED coding to ensure accurate ICD-10-CM, CPT, HCPCS codes.
• Assess E/M levels based on MDM guidelines and apply correct modifiers.
• Review encounters for compliance with AMA CPT guidelines and CMS rules.
• Identify coding trends and compliance risks through routine audits.
• Provide feedback to coders on accuracy, productivity, and docs improvement.
• Conduct one-on-one and group coaching to boost coding quality.
• Collaborate with Coding Leadership, Physicians, and Operations to fix issues.
• Monitor quality metrics and prepare audit reports and trend analyses.
• Assist in developing coding guidelines, tools, and SOPs.

Skills

ED coding expertise

MDM-based E/M coding

Regulatory knowledge

Analytical skills

Education

CPC/COC/CCS/CIC certification

Tools

Encoder systems

EHR platforms

Auditing tools

Job description

Key Responsibilities

• Perform quality audits of Emergency Department coding to ensure accurate assignment of: ICD-10-CM diagnosis codes
• CPT and HCPCS procedure codes
• E/M levels based on Medical Decision Making (MDM) guidelines
• Appropriate modifiers in accordance with coding guidelines and payer requirements.

• Review coded encounters for compliance with: AMA CPT guidelines
• CMS regulations
• NCCI edits
• Payer-specific coding requirements

• Validate the appropriate application of MDM components including: Number and complexity of problems addressed
• Amount and complexity of data reviewed
• Risk of complications and/or morbidity

• Identify coding trends, documentation deficiencies, and compliance risks through routine audits.
• Provide detailed and constructive feedback to coders regarding coding accuracy, productivity, and documentation opportunities.
• Conduct one-on-one and group feedback sessions to improve coding quality and consistency.
• Collaborate with Coding Leadership, Educators, Physicians, and Operational Teams to address coding issues and improve overall coding performance.
• Monitor coding quality metrics and prepare audit reports, scorecards, and trend analyses.
• Participate in root cause analysis for coding errors and implement corrective action plans.
• Assist in developing coding guidelines, audit tools, educational materials, and standard operating procedures.
• Support internal and external audit activities and respond to coding-related inquiries.
• Educate coders and providers on documentation requirements supporting accurate code assignment and E/M level selection.
• Stay current with: ICD-10-CM updates
• CPT and HCPCS changes
• CMS guidelines
• AMA E/M revisions
• ED-specific payer requirements

Qualifications

• Certification in Medical Coding: CPC, COC, CCS, CIC, or equivalent preferred

• Minimum 3 years of Emergency Department coding experience.
• Minimum 1-2 years of coding quality review, auditing, mentoring, or senior coding experience preferred.
• Strong understanding of: Emergency Department workflows
• MDM-based E/M coding guidelines
• ICD-10-CM, CPT, and HCPCS coding systems

• Experience reviewing provider documentation and identifying documentation improvement opportunities.
• Strong knowledge of coding compliance, regulatory requirements, and payer guidelines.
• Excellent analytical and problem‑solving skills.
• Strong communication and coaching abilities.
• High attention to detail and quality-focused mindset.

Preferred Skills

• Experience performing coding audits and quality assurance reviews.
• Ability to mentor and provide actionable feedback to coding teams.
• Experience with audit scorecards, accuracy tracking, and quality reporting.
• Strong understanding of NCCI edits, LCD/NCD guidelines, and payer‑specific reimbursement requirements.
• Proficiency in coding software, audit tools, encoder systems, and EHR platforms.
• Ability to identify coding trends and recommend process improvements.
• Strong organizational and time-management skills.
• Ability to work independently while collaborating effectively with cross-functional teams.
• Commitment to continuous learning and professional development.