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Medical Coder

2 months ago

bangalore, India DMAIC Academy & Consultancy Full time
Job Title: Medical Coding - Ancillary (Pathology, EM Primary Care, Preventive Visits, Urgent Care) QA Lead
Location: Bangalore / Chennai
Position Type: Full-Time
Experience Required: 5+ Years
Certification: CPC (Certified Professional Coder) or CCS (Certified Coding Specialist) - Mandatory
Job Summary:
We are seeking a highly skilled and experienced Medical Coding QA Lead with specialization in Ancillary services, including Pathology, EM Primary Care, Preventive Visits, and Urgent Care. The ideal candidate will have over 5 years of industry experience, a strong understanding of medical coding guidelines, and hands-on experience in quality assurance processes. This role involves managing a team of coders, ensuring that client production and coding accuracy goals are met, and contributing to continuous improvement initiatives.
Key Responsibilities:
Quality Assurance Oversight:
Monitor the performance of all coding staff using key metrics such as daily coding volume, assignment completion, client project deadlines, and coding accuracy to achieve and maintain a 95% coding quality accuracy rate.
Review production and quality accuracy reports to assess progress on assigned projects and provide actionable feedback.
Escalate production and QA concerns or roadblocks to the Manager as needed, ensuring timely resolution.
Team Leadership and Development:
Motivate and mentor team members through effective training, coaching, and continuous professional development to enhance quality and professionalism in work assignments.
Conduct monthly team meetings and annual performance evaluations with team members.
Assist in maintaining and monitoring team member job satisfaction and morale, fostering a positive work environment.
Operational Support:
Help the supervisor in preparing daily operational reports and participate in client interactions and internal stakeholder meetings to communicate progress and address challenges.
Monitor and maintain attendance records and timesheets for coding staff.
Complete special projects, such as full coding audits, and other duties as assigned in a timely manner.
Domain Expertise:
Demonstrate deep understanding of both the production and quality assurance coding processes and guidelines in Ancillary-Pathology and EM Surgery coding.
Utilize analytical and problem-solving skills to identify patterns and trends through data analysis, driving continuous improvement initiatives.
Stay updated on coding skills and industry knowledge by participating in coding team meetings and educational conferences.
Compliance and Regulatory Knowledge:
Maintain extensive knowledge of coding principles, hospital/technical and professional services reimbursement systems, and federal, state, and payer-specific regulations and policies related to documentation, coding, and billing for professional and technical services.
Ensure that all coding practices adhere to professional and ethical standards and compliance requirements, focusing on reducing revenue leakage for clients while maintaining high-quality standards.
Qualifications:
Education: Graduate or Post Graduate in Life Science, Pharmacy, Physiotherapy, Zoology, Microbiology, or a related discipline.
Experience: Minimum of 5 years of industry experience in medical coding with a focus on Ancillary services (Pathology, EM Primary Care, Preventive Visits, Urgent Care).
Certification: CPC (Certified Professional Coder) or CCS (Certified Coding Specialist) certification is mandatory.
Skills:
Strong managerial, leadership, and interpersonal skills.
Excellent communication skills with the ability to convey information effectively across a team with varying skill sets.
High attention to detail and strong technical and problem-solving abilities.
Ability to use data to identify patterns and trends, driving continuous improvement in coding quality and accuracy.