Professional, Quality Analysis
HyderabadFull-time5–9 yrsPosted 4 months ago
Senior legal role at Advantum Health in Hyderabad. Needs 5+ years.
About the role
The Quality Analyst – Surgery is responsible for performing detailed coding quality reviews, audits, and education related to surgical services. This role ensures accurate code assignment, documentation integrity, and compliance with federal regulations, payer policies, and organizational standards.
What you'll do
- Perform retrospective and prospective coding audits for surgical specialties (e.g., general surgery, cardiovascular, orthopedic, etc.)
- Evaluate coding accuracy for CPT, ICD-10-CM/PCS, and modifiers , ensuring compliance with: Official Coding Guidelines
- CMS and payer-specific policies
- Identify trends, root causes, and opportunities for improvement in coding quality and documentation
- Develop and deliver targeted education and feedback to coders and providers
What you need
- Documentation
- Medical coding
- Compliance