Same Day Surgery QA

Job description

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. Contact : Neela HR - 6385073741 and drop your resumes.