Professional, Quality Analysis (Surgery)
HyderabadFull-time6–11 yrsPosted 5 months ago
Senior finance role at Advantum Health in Hyderabad. Needs 6+ years.
About the role
The Coding Quality Analyst is responsible for assessing the accuracy, completeness, and compliance of medical coding practices across the organization. This role focuses on ensuring alignment between clinical documentation and coded data, supporting regulatory compliance, audit readiness, and revenue integrity.
What you'll do
- Conduct retrospective and prospective audits of coded records to evaluate accuracy, consistency, and compliance with applicable coding guidelines (e.g., ICD-10-CM, CPT
- Identify documentation and coding gaps, trends, and opportunities for improvement across service lines, with a focus on high-risk areas such as E/M, ED
- Provide clear, actionable feedback to coders and providers, including detailed audit results and education on best practices
- Develop and deliver coding and documentation education based on audit findings, regulatory updates, and organizational priorities
- Collaborate with CDI, revenue cycle, compliance, and clinical leadership to ensure accurate capture of clinical complexity and appropriate reimbursement
What you need
- Audit
- Compliance
- Medical coding
Good to have
- Reporting
- Data analysis