Senior Executive - Auditor/QA

Job description

- Job Description: Perform detailed quality audits of coded medical records to ensure accuracy, compliance, and adherence to official coding guidelines and payer-specific requirements. - Review and analyze clinical documentation for completeness and accuracy in assigning CPT, ICD-10-CM, and HCPCS codes. - Identify coding errors, trends, and areas for improvement; provide actionable feedback and recommendations to the coding team. - Collaborate with coding managers and training teams to support process improvement and coding education initiatives. - Stay current with updates to coding standards, payer regulations, and compliance requirements. - Responsibilities: Must be an expert - Team handling skill set - Working in Quality team is an added advantage. - Inventory management and planning - Motivate and guide team to achieve production and quality goal set - Follow project related protocols and instructions - Handling team clarification - To be proactive in handling team issues - Problem solving skill sets - Research on grey areas with solution - Capable of conducting team education and training - Skill sets to address client email and queries - Should have more analytical skill sets - Should be more innovative, energetic and positive thoughts - Having skill sets to motivate teams - Escalate issues, identify trends - All emails from Manager should be answered promptly without fail - Ensure compliance of entire team for HIPAA,OIG **Qualifications: Education - Bachelor’s Degree in Science or Nursing.** **Certifications** One or more of the following mandatory certifications: **CCS – Certified Coding Specialist** **CIC – Certified Inpatient Coder** **CPC – Certified Professional Coder** **Experience -** - 4 - 6 year of Coding with quality experience - Specialty worked: IVR – Mandatory (Must be dealt with complex level IVR coding, cardiovascular surgery and General surgery - 3+ years of coding experience - CPMA certification is added advantage. - Location –Chennai - QC experience Minimum **1–2 years of experience in a Quality Analyst or Quality Auditing role** . **Preferred Qualifications (Desirable Criteria)** Strong proficiency in **Microsoft Excel** , including trackers, analysis, and reporting. Experience working in SLA-driven, high-compliance healthcare environments.