
Professional Medical Record Analyst
5 days ago
Healthcare Coding Specialist
Key Responsibilities:- Analyze medical records for completeness and accuracy, assigning appropriate CPT, ICD-10-CM, HCPCS, and DRG codes.
- Ensure adherence to coding guidelines set by AAPC, AHIMA, CMS, and payer-specific requirements.
- Maintain high standards of coding accuracy and productivity.
- Collaborate with quality assurance and audit teams for continuous improvement.
- Stay up-to-date on current coding updates, payer policies, and CMS regulations.
- Evaluate and maintain HIPAA compliance.
- Assign accurate E/M codes for office visits, consultations, ER visits, and telehealth services.
- Interpret clinical documentation and apply 2021 E/M Guidelines.
- Review time-based and MDM criteria.
- Code operative reports across various specialties such as General Surgery, Orthopedics, ENT, and Gastroenterology.
- Understand bundling, modifier usage, and NCCI edits.
- Validate procedure codes against clinical documentation.
- Assign DRGs based on principal diagnosis, procedures, and comorbidities.
- Apply MS-DRG and APR-DRG grouping methodologies.
- IDentify POA indicators and query when needed.
Required Skills and Qualifications:
- Education: Bachelor's degree in Life Sciences or a related field.
- Certifications:
- Mandatory: CPC, CCS, or COC (AAPC or AHIMA)
- Preferred: CIC (for IPDRG), CGIC, CPMA, or specialty credentials
Benefits:
- Minimum 1–5 years of experience in respective coding specialties (E/M, Surgery, or Inpatient).
- Freshers with certification may apply for trainee roles.
Performance Metrics:
- Accuracy: ≥ 95% (based on QA audits)
- Productivity: Specialty-based benchmarks
- Compliance: Zero PHI breaches; adherence to internal SLAs
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