Quality Auditor

9 hours ago

Noida, Uttar Pradesh, India HOM Full time ₹ 12,00,000 - ₹ 24,00,000 per year
Job Title: Quality Auditor – Medical Coding (HCC) Location: Office-Based  Experience Required: 3–6 Years  Employment Type: Full-TimeRoles & Responsibilities
  • Review and audit coded medical charts to ensure accuracy, completeness, and compliance with ICD-10 and CPT guidelines.
  • Conduct quality audits specifically for HCC-coded charts, ensuring adherence to CMS risk adjustment coding requirements.
  • Identify documentation gaps, coding errors, and trends across multi-specialty charts (e.g., E/M, ED)
  • Work closely with the coding team to provide constructive feedback and training based on audit findings.
  • Maintain audit records and prepare quality reports reflecting coder performance and compliance issues.
  • Support the development of corrective and preventive action plans (CAPA) to address audit findings.
  • Assist in maintaining client-specific coding accuracy benchmarks, typically 96% or higher, and support continuous improvement efforts.
  • Stay updated with ICD-10, CPT, CMS, and payer-specific guidelines, and ensure coders are updated on changes.
Requirements Only those candidates may apply who:
  • Have 3 to 6 years of experience in medical coding and/or chart auditing.
  • Have hands-on experience in HCC coding; experience with multi-specialty coding is also acceptable.
  • Possess strong expertise in ICD-10-CM guidelines and application across various specialties.
  • Certified in CPC, CRC, COC, or CCS or equivalent AAPC/AHIMA certification.
  • Have experience in reviewing coded charts for quality and providing performance feedback.
  • Are proficient in Microsoft Office tools (especially Excel and Word).
  • Maintain a high level of professional integrity, attention to detail, and a commitment to quality standards.

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