Job Opening as a Multi-Specialty E/M Auditor

Experience

- 2 to 4 years of experience in Multi-Specialty Evaluation & Management (E/M) Auditing.
- Experience auditing physician documentation and coding for Outpatient, Inpatient, SNF/NF, ALF, Home Visits, Telehealth, and other E/M services.

Educational Qualification

- Bachelors degree in Pharmacy, Life Sciences, Nursing, Biotechnology, or Allied Health Sciences.
- CPC, CPMA, CCS, CRC, or equivalent certification is preferred.

Key Responsibilities

- Audit physician documentation and E/M coding for accuracy, compliance, and medical necessity.
- Validate E/M level selection based on Medical Decision Making (MDM) and Time-Based Coding guidelines.
- Identify documentation deficiencies, coding errors, and compliance risks, and provide constructive feedback to providers and coding teams.
- Recognize recurring documentation and coding trends, perform root cause analysis, and recommend corrective actions.
- Develop and deliver targeted education sessions for coders, auditors, and providers to improve coding quality and documentation practices.
- Review audit findings, classify error categories, and support continuous quality improvement initiatives.
- Identify potential denial risks and recommend preventive measures to improve first-pass claim acceptance.
- Ensure compliance with CMS,



AMA, Medicare, Medicaid, Commercial Payer, LCD/NCD, and NCCI guidelines.

Required Knowledge & Skills
Candidates should have strong knowledge of:

- Current AMA and CMS E/M Guidelines across all applicable E/M services.
- Extensive knowledge of Medical Decision Making (MDM) and Time-Based Coding.
- ICD-10-CM, CPT, and HCPCS coding.
- CMS, AMA, Medicare, Medicaid, and Commercial Payer guidelines.
- LCD/NCD policies, NCCI edits, and Medical Necessity requirements.
- Common claim denial reasons, denial prevention strategies, and documentation improvement techniques.
- Root cause analysis of coding and documentation errors with the ability to implement effective corrective and preventive actions (CAPA).
- Provider documentation improvement and coder education methodologies.

Preferred Skills

- Robust analytical and critical thinking skills.
- Excellent written and verbal communication.
- Ability to educate providers and coding teams effectively.
- High attention to detail with a focus on quality and compliance.
- Ability to work independently while meeting productivity and quality expectations.

Interested Candidates can share their profiles / CV of the below email id
[email protected]

📌 Immediate Hiring For Multi-Speciality E/M Auditor (Mumbai)
🏢 Medmecs Billing Services
📍 Mumbai