The ED Profee Medical Coder is responsible for reviewing, analyzing, and assigning accurate CPT, ICD-10-CM, HCPCS, and E&M; codes for Emergency Department professional fee encounters. The coder ensures compliance with client requirements, payer regulations, CMS guidelines, and coding standards while maintaining productivity and quality targets.
Key Responsibilities
- Review Emergency Department physician documentation and assign appropriate:
- CPT codes
- ICD-10-CM diagnosis codes
- HCPCS codes
- E&M; levels based on documentation
- Ensure coding accuracy and compliance with CMS, AMA, CPT, and coding guidelines.
- Abstract clinical information from medical records and apply correct coding principles.
- Query providers when documentation is incomplete or unclear.
- Identify coding opportunities and documentation improvement areas.
- Meet established productivity and quality benchmarks.
- Participate in internal and external coding audits.
- Stay updated with coding changes, payer regulations,
and industry best practices.
- Maintain confidentiality and HIPAA compliance.
Required Qualifications
- Certified Skilled Coder (CPC) from AAPC or Certified Coding Specialist (CCS) from AHIMA.
- Minimum 1+ years of ED Profee coding experience.
- Strong knowledge of:
- Emergency Medicine coding
- E&M; guidelines
- CPT, ICD-10-CM, and HCPCS coding systems
- Medical terminology, anatomy, and physiology
- Experience working with EMR/EHR systems and encoder tools.
- Strong analytical and communication skills.
Preferred Qualifications
- Experience with Leveling Guidelines for Emergency Department encounters.
- Familiarity with US healthcare payer regulations and reimbursement methodologies.
- Experience in coding audits and quality assurance processes.
Work Location: Navi Mumbai Interested Candidates can Reach out to HR Vedha Mithra (phone hidden)
📌 ED Profee Coders/QA (Mumbai)
🏢 ECLAT Health Solutions
📍 Mumbai
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