Description
We are seeking a skilled and experienced Medical Coder – ED/EM/Surgery to join our team. The successful candidate will be responsible for accurately coding medical procedures and diagnoses for emergency department, emergency medicine and surgery services. The candidate should have 1-5 years of experience in the job market context of India, and be familiar with ICD-10, CPT and HCPCS coding systems.
Job Responsibilities:
For Surgery Coding:
- Assign ICD-10, CPT, and HCPCS codes for a variety of surgical procedures, both inpatient and outpatient.
- Ensure the correct use of modifiers for surgical procedures and apply proper coding for pre-operative, intra-operative, and post-operative care.
- Review operative reports, anesthesia records, and pathology reports to ensure accurate coding.
- Ensure compliance with global surgical package rules and payer-specific guidelines.
For Denial Coding:
- Review and analyze denied claims to identify reasons for denials related to coding errors, insufficient documentation, or payer policy issues.
- Correct and resubmit claims to improve reimbursement, ensuring accurate ICD-10, CPT, and HCPCS coding.
- Collaborate with the billing department and healthcare providers to resolve coding issues that lead to denials.
- Keep track of denial trends and develop strategies to prevent future claim rejections.
- Maintain up-to-date knowledge of payer-specific policies, regulatory changes, and medical coding guidelines.
For Medical Coding QA (Quality Assurance):
- Conduct coding audits to ensure accuracy, compliance, and adherence to industry guidelines (such as ICD-10, CPT, HCPCS).
- Review and correct coding errors identified by junior coders or during internal audits.
- Provide feedback and training to coders to improve coding accuracy and adherence to coding standards.
- Generate detailed QA reports and track coding errors or inconsistencies for continuous improvement.
- Collaborate with the coding team to maintain high-quality standards in coding practices.
Key Requirements:
- Certification: CPC, CCS, CIC, or relevant certification (Preferred). Non-certified candidates can also apply.
- Experience: 1+ years of experience in Surgery Coding, Denial Coding, or Medical Coding QA (Trainee positions available for freshers).
- Strong knowledge of ICD-10, CPT, HCPCS, and coding guidelines for surgical procedures, denial management, and quality assurance.
- Familiarity with EHR/EMR systems such as Epic, Meditech, 3M, etc.
- Denial management experience: Ability to analyze and resolve coding-related denials effectively.
- Ability to work with coding audits, documentation reviews, and correction of coding errors.
- Knowledge of coding compliance and payer-specific rules.
