Medical Records Auditor

4 days ago


Chennai, Tamil Nadu, India exl Full time

Job Description

Overview:

  • The Senior Executive Coding Auditor performs thorough reviews of medical records to assess completeness and accuracy of provider documentation and CPT and HCPCS coding.
  • Ensure compliance with established coding guidelines, third-party reimbursement policies, regulations, and accreditation guidelines.
  • Perform analysis of data and understand reasons for denial reasons, using appropriate codes to document the reasons for denials.

Qualifications:

  • Lifescience Bachelor's degree.
  • Para-medical background (B.PT, Pharm, and B.SC. Nursing) is an added advantage.
  • Certification is an added advantage – Certified Coding Professional Coder (CPC) – AAPC or Certified Coding Specialist (CCS) – AHIMA.

Experience:

  • Minimum 5 to 8 years of coding experience in multispecialty surgery.
  • Denial management experience is an added advantage.
  • Ability to apply analytical and critical thinking to review medical records.
  • Knowledge in CMS Medicare and Medicaid guidelines.
  • Specialty certificate (CPMA, CIRCC, CEDC) from – AAPC.

Skills and Abilities:

  • Integrate coding principles in performance of medical audit activity and educate as needed on those principles.
  • Compile detailed findings and prepare client reports, when needed.
  • Communicate properly to ensure patient data is received and processed for all scheduled audit work.
  • Provide feedback and process improvement recommendations to appropriate leadership team and participate in workgroups/committee meetings and process improvement solutions as required.


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