Experience Required: Minimum 3+ Years

Department: Medical Coding

Location: Noida, 142

Job Summary

We are seeking an experienced and detail-oriented QA Analyst - Senior Medical Coder to perform quality audits and ensure accuracy in medical coding and claim processing related to Edits & Denials, EM OP, EM IP, ED Facility, and ED Professional (ProFee) services. The ideal candidate will possess strong knowledge of coding guidelines, payer regulations, and denial management processes to support quality improvement initiatives.

Key Responsibilities
Perform quality audits on medical coding and billing processes for:
Emergency Department Facility (ED Facility)
Emergency Department Qualified Fee (ED ProFee)
Evaluation & Management Outpatient (EM OP)
Evaluation & Management Inpatient (EM IP)
Edits and Denials Management
Review coded charts and claims for accuracy, completeness, and compliance with regulatory guidelines.
Identify coding errors, documentation gaps, and denial trends.
Conduct root cause analysis for coding and billing discrepancies.
Provide feedback and coaching to coders based on audit findings.
Ensure compliance with ICD-10-CM, CPT, HCPCS, and payer-specific guidelines.
Monitor key quality metrics and prepare audit reports.
Collaborate with operations,



coding teams, and clients to improve coding accuracy and reduce denials.
Support internal and external audit requirements.
Stay updated on coding regulations, payer updates, and industry changes.

Required Skills & Qualifications

Education
Graduate in any discipline.
Certification preferred: CPC, CCS, CIC, COC, or equivalent.

Experience
Minimum 3 years of experience in Medical Coding QA/Auditing.

Technical Skills
Robust knowledge of ICD-10-CM, CPT, and HCPCS coding systems.
Expertise in payer edits, denial management, and claim correction processes.
Understanding of coding compliance and reimbursement methodologies.
Proficient in audit tools, coding software, and EMR/EHR systems.

Soft Skills
Robust analytical and problem-solving abilities.
Excellent communication and feedback skills.
Attention to detail and quality-focused mindset.
Ability to work independently and manage multiple priorities.

Key Performance Indicators (KPIs)
Coding Accuracy 95%
Audit Quality Compliance
Denial Reduction Rate
Productivity Targets
Timely Completion of Quality Reviews

Preferred Certifications: CPC, CCS, CIC, COC, RHIT, RHIA.

📌 Huge Openings Senior Medical Coding Noida (India)
🏢 CorroHealth
📍 India