Senior Executive - Auditor/QA

• Perform detailed quality audits of coded medical records to ensure accuracy, compliance, and adherence to official coding guidelines and payer-specific requirements.
• Review and analyze clinical documentation for completeness and accuracy in assigning CPT, ICD-10-CM, and HCPCS codes.
• Identify coding errors, trends, and areas for improvement; provide actionable feedback and recommendations to the coding team.
• Collaborate with coding managers and training teams to support process improvement and coding education initiatives.
• Stay current with updates to coding standards, payer regulations, and compliance requirements.

Responsibilities

• • Must be an expert
  • Team handling skill set
  • Working in Quality team is an added advantage.
  • Inventory management and planning
  • Motivate and guide team to achieve production and quality goal set
  • Follow project related protocols  and instructions
  • Handling team clarification
  • To be proactive in handling team issues
  • Problem solving skill sets
  • Research on grey areas with solution
  • Capable of conducting team education and training
  • Skill sets to address client email and queries
  • Should have more analytical skill sets
  • Should be more innovative, energetic and positive thoughts
  • Having skill sets to motivate teams
  • Escalate issues, identify trends
  • All emails from Manager should be answered promptly without fail
  • Ensure compliance of entire team for HIPAA,OIG

Qualifications

• Education - Bachelor’s Degree in Science or Nursing.

  Certifications

  One or more of the following mandatory certifications:

  CCS – Certified Coding Specialist

  CIC – Certified Inpatient Coder

  CPC – Certified Professional Coder

  Experience - 

  • 4 - 6 year of Coding with quality experience 
  • Specialty worked: IVR – Mandatory (Must be dealt with complex level IVR coding, cardiovascular surgery and General surgery
  • 3+ years of coding experience
  • CPMA certification is added advantage.
  • Location –Chennai
  • QC experience

  Minimum 1–2 years of experience in a Quality Analyst or Quality Auditing role.

  Preferred Qualifications (Desirable Criteria)

  Strong proficiency in Microsoft Excel, including trackers, analysis, and reporting.

  Experience working in SLA-driven, high-compliance healthcare environments.