Job Categories : Quality Controller (Coding)
Job Types : Full Time
Job Locations:Chennai, India
Minimum experience: 6-8 years
Requirements : 1
Coding auditor provides education to coders based on audit findings; provides general education on ICD-10, CPT, HCPCS codes and modifiers as appropriate. Highlight/Escalate any major issues to the management.
Roles and Responsibilities:
- Performs coding compliance audits on E&M visits/encounters in all settings/sites (professional and technical), and/or CPT coded services performed by clinical institutes and/or physicians, using criteria based on official CPT and ICD-10 guidelines and other applicable regulations
- Performs inpatient coding audits using ICD-10-CM/PCS, DRG validation utilizing appropriate coding references for hospitals via scanned, electronic and hybrid medical records
- Performs centralized outpatient coding audits of scanned or copied medical records and abstracts using ICD-10-CM and CPT and appropriate coding references, for CHS hospitals and CCS coding staff
- Stays current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-10 coding
- Develop and conduct ongoing coding training to include but not limited to ICD-10-CM and Medicare Risk Adjustment coding to new associates, training for existing staff as needed
- Attend the Compliance Committee meetings
- Provide other services as needed to assist in effective operations of the compliance program
- Work with CHKS clients both in the NHS and private sector by undertaking regular complex audits of clinically coded data to assess coding quality for accuracy, completeness, consistency and timeliness
- To support clients in the development of audit programmes to ensure ongoing improvements in their quality assurance for both the organisation and their commissioners
- Have a pro-active and positive approach when working with clients to identify areas where further work may be required, for example training or more specialised audit
SKILLS REQUIRED (If any)
- Should have multispeciality coding and audit experience
- Knowledge in CDI will be an added advantage
- Medical coding certification through either AAPC or AHIMA: CPC/COC/CIC/CCS.
- Strong understanding of healthcare principles and concepts.
- Good at creating SOPs Process mapping.
- Strong Client interaction and Management Skills.
- Good Communication Skills, Analytical Skills and Interpersonal Skills