Role & responsibilities

- Review laboratory requisitions, physician orders, pathology reports, and supporting clinical documentation.
- Assign accurate ICD-10-CM diagnosis codes to laboratory encounters.
- Validate medical necessity based on payer-specific Local Coverage Determinations (LCDs), National Coverage Determinations (NCDs), and client guidelines.
- Identify missing, invalid, or conflicting documentation and escalate according to established processes.
- Ensure coding complies with ICD-10-CM Official Guidelines, CMS regulations, and client-specific coding policies.
- Verify diagnosis sequencing and coding completeness.
- Maintain productivity, quality, and turnaround time (TAT) targets.
- Participate in client updates, education sessions, and process improvement initiatives.
- Maintain confidentiality and comply with HIPAA regulations.
- Document coding decisions and maintain audit trails where applicable.
- Communicate coding-related issues to Team Leads and Quality Analysts.

Required Qualifications





- Graduate in Life Sciences, Pharmacy, Nursing, or an equivalent healthcare-related field.
- Certification such as CPC, CCS, COC, CIC, or RHIT/RHIA preferred.
- 13 years of experience in laboratory or ancillary medical coding.
- Strong knowledge of ICD-10-CM coding guidelines.
- Familiarity with laboratory testing, pathology, molecular diagnostics, and medical necessity guidelines.
- Experience using coding encoders (3M, Optum, TruCode, etc.) and EHR systems.
- Valuable analytical and communication skills.
- Proficiency in Microsoft Excel and Microsoft Office applications.

Preferred candidate profile

- LCD/NCD policies.
- Medical necessity validation.
- Clinical laboratory workflow.
- Pathology and molecular laboratory coding concepts.
- HIPAA and compliance standards.

- Contact Details
- HR Apoorva
- (phone hidden)
- [email protected]

📌 Urgent Hiring For Ancillary Coder (Hyderabad)
🏢 Eclat Health Solutions
📍 Hyderabad