Same Day Surgery QA

Access Healthcare; Chennai District; Teletrabalho; INR 500 000 - 800 000; Tempo integral

Resumo da oferta

Access Healthcare in India is seeking an experienced Medical Coder with 13+ years of experience in Same Day Surgery/outpatient coding. You will review records, assign ICD-10-CM/CPT/HCPCS codes, and ensure accurate coding with NCCI edits and payer guidelines.

The role requires knowledge of surgical procedures, medical terminology, and HIPAA compliance. Willingness to work US healthcare night shifts is preferred; candidates with US RCM experience will be favored.

Qualificações

• Graduate in Life Sciences or Nursing or Pharmacy or Allied Health Sciences or Medical-related fields.
• 13+ years of medical coding experience, preferably Same Day Surgery/Outpatient/Ambulatory Surgery coding.
• Strong knowledge of ICD-10-CM, CPT, HCPCS and modifiers.
• Good understanding of surgical procedures, anatomy, and medical terminology.
• Experience with Surgery/Outpatient coding; knowledge of NCCI edits and bundling guidelines.
• Willingness to work in US healthcare / night shifts if required.

Responsabilidades

• Review and analyze medical records, operative notes, and physician documentation for Same Day Surgery cases.
• Assign accurate ICD-10-CM, CPT, and HCPCS codes based on clinical documentation.
• Code outpatient surgical procedures, diagnoses, complications, and comorbidities.
• Ensure accurate CPT coding, modifiers, bundling, and NCCI edits.
• Validate medical necessity and ensure diagnosis-to-procedure coding accuracy.
• Identify documentation gaps and raise physician queries when required.
• Follow AMA CPT, ICD-10-CM, CMS, and payer-specific coding guidelines.
• Perform quality checks to maintain coding accuracy and compliance.
• Meet defined productivity, quality, and turnaround-time targets.
• Review and resolve coding-related errors, denials, and client queries.
• Stay updated with annual changes in ICD-10-CM, CPT, HCPCS, and payer guidelines.
• Maintain patient confidentiality and HIPAA compliance.

Conhecimentos

ICD-10-CM knowledge

CPT knowledge

HCPCS knowledge

Medical coding

Formação académica

CPC, CCS, CCA or equivalent medical coding certification

Ferramentas

NCCI edits

Coding modifiers

Descrição da oferta de emprego

Role & responsibilities

• Review and analyze medical records, operative notes, and physician documentation for Same Day Surgery cases.
• Assign accurate ICD-10-CM, CPT, and HCPCS codes based on clinical documentation.
• Code outpatient surgical procedures, diagnoses, complications, and comorbidities as applicable.
• Ensure accurate CPT coding, modifiers, bundling, and NCCI edits as per coding guidelines.
• Validate medical necessity and ensure diagnosis-to-procedure coding accuracy.
• Identify documentation gaps and raise physician queries when required.
• Follow AMA CPT, ICD-10-CM, CMS, and payer-specific coding guidelines.
• Perform quality checks to maintain coding accuracy and compliance.
• Meet defined productivity, quality, and turnaround-time (TAT) targets.
• Review and resolve coding-related errors, denials, and client queries.
• Stay updated with annual changes in ICD-10-CM, CPT, HCPCS, and payer guidelines.
• Maintain patient confidentiality and comply with HIPAA and organizational policies.

Preferred candidate profile

• Graduate in Life Sciences, Nursing, Pharmacy, Allied Health Sciences, or Medical-related fields.
• 13 years of experience in medical coding, preferably in Same Day Surgery / Outpatient / Ambulatory Surgery coding.
• Strong knowledge of ICD-10-CM, CPT, HCPCS, and modifiers.
• Good understanding of surgical procedures, anatomy, and medical terminology.
• Experience with Surgery/Outpatient coding and knowledge of NCCI edits and bundling guidelines.
• CPC, CCS, CCA, or equivalent medical coding certification is preferred.
• Good analytical and documentation-review skills.
• Ability to meet quality, productivity, and TAT targets.
• Good written and verbal communication skills.
• Willingness to work in US healthcare / night shifts if required.
• Candidates with experience in US healthcare RCM and medical coding will be preferred.