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ENM OP

4 weeks ago

Chennai, Tamil Nadu, India Axis Services Full time
Job Description

Key Responsibilities:

Medical Coding Responsibilities:

- Review clinical documentation and assign accurate codes for ENM OP visits, Emergency Department (ED) services, and Surgical procedures using ICD-10-CM, CPT, and HCPCS coding systems.
- Apply knowledge of CPT modifiers, NCCI edits, bundling, and payer-specific guidelines.
- Ensure compliance with CMS, AAPC, AHIMA, and other regulatory standards.
- Clarify documentation through provider queries when necessary.
- Collaborate with billing and clinical teams for smooth claim submission.

Quality Assurance (QA) Responsibilities:

- Perform detailed audits on coded medical records to ensure accuracy and completeness.
- Identify coding errors, inconsistencies, and opportunities for improvement.
- Provide feedback and coaching to coding teams to enhance coding quality.
- Prepare QA reports and maintain documentation for compliance and audits.
- Monitor compliance with internal SLAs and external regulatory requirements.

Requirements:

- Education: Graduate in Life Sciences, Paramedical, or Healthcare-related fields.
- Certifications: CPC, CCS, COC, or equivalent medical coding certifications mandatory. QA certifications or training preferred.
- Experience:
- Minimum 15 years coding experience in ENM OP, ED facility, and surgical coding.
- QA experience in healthcare coding is an added advantage.
- Tools: Proficiency in EMR/EHR systems (Epic, Cerner, Meditech) and coding software (3M, TruCode, Optum Encoder).
- Skills: Strong knowledge of medical terminology, anatomy, and coding guidelines. Attention to detail and analytical mindset.