Quality Analyst- IPDRG

Optum; Hyderabad, Chennai; On-site; INR 600,000 - 900,000; Full time

Job summary

Optum is hiring for Quality Auditors in IPDRG Coding located in Hyderabad, Chennai and Noida. The role involves auditing coded medical records and ensuring accuracy with ICD-10 and CPT, while maintaining HIPAA compliance.

Post-training, you will provide feedback, conduct calibration sessions between SMEs and auditors, and educate coders on coding updates and error trends.

Qualifications

• Graduate or postgraduate in Life Sciences or Allied Medicine.
• Certified coder as per AAPC/AHIMA – CCS/CPC/CPC-H/CCS-P.
• Minimum 6 years of coding experience in relevant specialty.
• Good in English communication and medical terminology.

Responsibilities

• Auditing coded medical records using ICD-10 and CPT.
• Adhere to HIPAA regulations and data privacy.
• Identify inconsistencies and query responsible parties for resolution.
• Meet quality and productivity standards with deadlines.

Skills

English communication

Medical terminology

Anatomy & physiology

Training & feedback

Education

Certification: AAPC / AHIMA – CCS/CPC/CPC-H/CCS-P

6+ years medical coding experience

Life Sciences / Allied Medicine background

Job description

Greeting From Optum!!

Optum is hiring Quality Auditors for IPDRG Coding in Hyderabad ,Chennai & Noida

Medical Coding QA - IPDRG

Requirements

• Education Background:
• Graduate or Postgraduate in: Life Sciences, Allied Medicine (BHMS, BAMS, BPT, Dental Grads, Pharmacist, Nursing)
• Certification:
• Should be a certified coder AAPC / AHIMA – CCS/CPC/CPC-H/CCS-P
• Good in English communication
• Thorough knowledge of medical terminology, human anatomy/ physiology, pathophysiology
• Should have understanding of interpreting the medications and dosages.
• Should have minimum of 6 yrs. coding experience in relevant specialty.
• Should be able to provide proper and detailed feedback on errors and conduct/provide training based on error trends.
• Should be able to participate/conduct/lead calibrations between SMEs, auditors and trainer group.

Roles and Responsibilities post training:

• Auditing coded medical records using the ICD-10 and CPT.
• Know and adhere to HIPAA regulations.
• Recognize, interpret and evaluate inconsistencies, discrepancies and inaccuracies in the medical data received and appropriately alert and/or query the responsible party, coder and supervisor.
• Meet auditor quality and productivity standards and deadlines/turnaround times set up for the process.
• Educate coders through feedback on errors.
• Analyze, report and conduct sessions on error trend observed.
• Conduct/participate/lead calibration calls between SMEs, auditors and trainers.
• Report malpractices noticed during auditing of any coder.
• Educate coders on coding updates.
• Carefully demarcates between educational feedback and errors.
• Reviews rebuttals with integrity.