Role & responsibilities

- Conduct retrospective and prospective audits of coded records to evaluate accuracy, consistency, and compliance with applicable coding guidelines (e.g., ICD-10-CM, CPT, E/M guidelines, and payer-specific requirements)
- Identify documentation and coding gaps, trends, and opportunities for improvement across service lines, with a focus on high-risk areas such as E/M, ED, and specialty coding
- Provide explicit, actionable feedback to coders and providers, including detailed audit results and education on best practices
- Develop and deliver coding and documentation education based on audit findings, regulatory updates, and organizational priorities
- Collaborate with CDI, revenue cycle, compliance, and clinical leadership to ensure accurate capture of clinical complexity and appropriate reimbursement
- Support internal and external audit activities,



including payer audits, regulatory reviews, and compliance initiatives
- Track and report key performance metrics, including coding accuracy rates, error trends, and audit outcomes
- Assist in the development and maintenance of coding policies, procedures, and training materials
- Serve as a subject matter expert for coding-related inquiries, providing guidance on complex cases and documentation scenarios
- Stay current on regulatory changes, coding updates, and industry best practices, and ensure timely dissemination of relevant information.

Please call or share your profile via Whatsapp on (phone hidden) Thanks & Regards,

Navya Miryalkar

Advantum Health

📌 E/M Quality Analysis (Hyderabad)
🏢 Advantum Health
📍 Hyderabad