Revenue Integrity Coders and QA with Surgery and ED Combination

Eclat Health; Navi Mumbai; On-site; INR 900,000 - 1,500,000; Full time

Job summary

Eclat Health is seeking experienced Revenue Integrity Coders for our Surgery and ED Revenue Integrity team in Mumbai. This role requires hands-on Revenue Integrity experience including charge entry, validation, capture, documentation review, and audits to prevent revenue leakage.

Ideal candidates will have expertise in CPT, ICD-10-CM and HCPCS coding, with a focus on denials management and compliant coding practices in a US shift environment.

Qualifications

• Must have Revenue Integrity experience with hands-on involvement.
• Experience in Charge Entry, Validation, Capture and Documentation Review.
• Knowledge of CMS, NCCI, payer guidelines and denials management.
• Only Revenue Integrity profiles will be considered.

Responsibilities

• Review operative reports, physician documentation, and ED records.
• Assign accurate ICD-10-CM, CPT, and HCPCS codes.
• Perform charge validation and charge capture reviews.
• Identify missed charges and revenue leakage opportunities.
• Perform documentation reviews and coding audits.
• Analyze coding denials and recommend corrective actions.
• Ensure compliance with CMS, NCCI, payer guidelines and client requirements.
• Achieve productivity, quality, and SLA targets.

Skills

Revenue Integrity

Charge Entry

Charge Validation

Charge Capture

Surgery Coding

ED Coding

Observation Coding

Denials Management

Documentation Review

Coding Audits

CPT

ICD-10-CM

HCPCS

Tools

CPT

ICD-10-CM

HCPCS

Job description

Location: Mumbai (Work from Office)

Experience: 3 - 8 Years

Shift: US Shift

Notice Period: Immediate to 30 Days Preferred

Job Summary

Eclat Health Solutions is hiring experienced Revenue Integrity Coders for our Surgery & Emergency Department (ED) Revenue Integrity team.

Revenue Integrity experience is MANDATORY.

We are specifically looking for professionals with hands-on experience in Revenue Integrity functions such as Charge Entry, Charge Validation, Charge Capture, Documentation Review, Coding Audits, Denials Management, and Revenue Leakage Prevention.

Candidates with only Medical Coding experience and no Revenue Integrity exposure will not be contacted.

HCC, Risk Adjustment, General Medical Coding, Medical Billing, AR Calling, Payment Posting, or unrelated coding profiles without Revenue Integrity experience will not be considered.

Required Specialty Exposure

• Revenue Integrity
• Surgery Coding
• Same Day Surgery
• Emergency Department (ED)
• Observation Coding
• Charge Entry
• Charge Validation
• Denials Management
• Documentation Review
• Coding Audits
• Charge Capture
• Revenue Leakage Identification

Key Responsibilities

• Review operative reports, physician documentation, and ED records.
• Assign accurate ICD-10-CM, CPT, and HCPCS codes.
• Perform charge validation and charge capture reviews.
• Identify missed charges and revenue leakage opportunities.
• Perform documentation reviews and coding audits.
• Analyze coding denials and recommend corrective actions.
• Ensure compliance with CMS, NCCI, payer-specific, and client guidelines.
• Achieve productivity, quality, and SLA targets.

Mandatory Skills

Revenue Integrity, Charge Entry, Charge Validation, Charge Capture, Surgery Coding, ED Coding, Observation Coding, Denials, CPT, ICD-10-CM, HCPCS, Documentation Review, Coding Audits.

Preferred Certifications

• CPC
• CCS
• COC