Surgery, ENM , IPDRG ( Coder || QA )

Key Responsibilities:

For Medical Coders:

• Review and abstract clinical documentation for surgical procedures, office visits (E&M), and inpatient encounters.
• Assign accurate ICD-10-CM, CPT, HCPCS, and MS-DRG/APR-DRG codes.
• Ensure 100% adherence to coding guidelines (CMS, AHA, AMA).
• Identify and escalate documentation deficiencies or ambiguities.
• Meet daily coding productivity and accuracy benchmarks.

For Quality Analysts:

• Audit coded charts across Surgery, E&M, and Inpatient DRG for accuracy and compliance.
• Provide constructive feedback and re-training to coders based on audit findings.
• Support client deliverables and ensure SLA adherence for quality.
• Collaborate with compliance, training, and operations teams to drive coding excellence.

Eligibility Criteria:

• Education: Any Life Science / Paramedical Graduate (B.Sc, BPT, B.Pharm, etc.)
• Certification (Mandatory): AAPC or AHIMA Certified (e.g., CPC, CCS, COC)
• Experience:
• 25 years of coding experience in Surgery, E&M, or Inpatient DRG
• Prior QA/Auditor experience preferred for QA roles
• Familiarity with MS-DRG, APR-DRG, POA indicators, and medical necessity guidelines

Key Skills:

• In-depth knowledge of ICD-10-CM, CPT, HCPCS, DRG grouping
• Strong clinical knowledge and ability to interpret operative/progress notes
• Accuracy in applying modifiers, units, and sequencing
• Proficiency in using encoders (3M, TruCode, Optum) and EHRs
• Excellent verbal and written communication for QA feedback or queries
• Strong understanding of NCCI edits, LCD/NCD guidelines, and payer-specific rules