Professional, Quality Analysis (EM)- Pain
HyderabadFull-time6–7 yrsPosted over a month ago
Senior legal role at Advantum Health in Hyderabad. Needs 6–7 years.
About the role
Medical Coding Professional with 6+ years of overall experience , including 2-3 years of Quality Analysis (QA) experience in physician and outpatient coding. Expertise in Professional Fee (ProFee) Evaluation & Management (E/M) coding with thorough knowledge of CMS, CPT, ICD-10-CM, and HCPCS guidelines.
What you'll do
- Conduct detailed coding audits, error trend analysis, and root cause identification to improve coding quality and accuracy
- Provide coder feedback, education, and mentoring to ensure adherence to client-specific and regulatory coding standards
- Analyze provider documentation to validate code selection, modifier usage, and medical necessity requirements
- Monitor quality metrics, prepare audit reports, and recommend process improvements to enhance operational efficiency
What you need
- Compliance
- Medical coding
- Documentation