Medical Coding Quality Analyst

Medical Coding Quality Analyst

Role-Medical Coding Quality Analyst (QA) / Medical Coding Auditor

Experience- 3 to 5 years, with hands-on coding and auditing experience

Location- Hyderabad, Telangana, India (On-site)

Shift-General shift, 9:30 AM to 6:30 PM IST, Tuesday to Sunday

Joining-Immediate joiners preferred

Employment type- Full-time

Reporting to-Quality Manager / Project Lead

About Novetum

Novetum builds AI-based products and services that help enterprises adopt intelligent automation, generative AI and data-driven decision-making. Our healthcare team delivers accurate, reliable and compliant solutions for global clients.

Role Summary

The Quality Analyst conducts pre-bill and post-bill audits on coded charts. The role ensures strict adherence to coding guidelines, minimizes error rates and drives project accuracy metrics.

Key Responsibilities

• Audit and validation: Randomly or systematically audit charts coded by project users to verify the accuracy of ICD-10, CPT and modifier assignments.

• Error tracking and root cause analysis: Identify coding discrepancies, document error patterns, and analyze root causes of miscoding or compliance gaps.

• Feedback and mentorship: Give clear, constructive feedback and one-on-one coaching to coders to resolve recurring errors and bridge knowledge gaps.

• Client compliance: Ensure all coding conforms to HIPAA regulations, project scope and client-specific contractual guidelines.

• Reporting: Prepare daily, weekly and monthly quality metrics, defect logs and audit summary reports for management review.

• Process enhancement: Assist project leadership in updating coding cheat sheets, workflow manuals and quality matrices based on audit trends.

Requirements and Skills

• Minimum 3+ years of medical coding experience, with at least 1–2 years in a dedicated QA or auditing role.

• Active professional certification (CPMA, CPC or CCS) from AAPC or AHIMA.

• In-depth knowledge of multi-specialty coding, billing rules and compliance standards.

• Exceptional attention to detail, analytical mindset, and data-handling proficiency (Excel, reporting tools).

• Strong interpersonal skills to deliver constructive feedback without friction.

Preferred Qualifications

• Graduate in Life Sciences (B.Sc, M.Sc, Nursing, Pharm.D) or equivalent.

• Experience with audit frameworks and accuracy benchmarks (typically 95%–98% or higher).

• Exposure to specialty coding such as risk adjustment or HCC audits is an advantage.

• Experience with EHR systems, coding and audit tools, and dashboards or MIS reporting.

• Prior experience training or mentoring coders.

Other Requirements

• Strong written and verbal communication skills.

• Ability to work independently and meet reporting deadlines.

• Flexibility to adjust shift timings occasionally as required by the project.

• Commitment to confidentiality of patient data and compliance.