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Senior Quality Auditor, Medical Coding – EXL, Chennai Hybrid
Senior healthcare quality auditor role at EXL focused on IVR medical coding accuracy, compliance, and clinical documentation. Lead coding quality improvements and support coding teams in Chennai.
विवरण
- Audit coded medical records for accuracy, compliance, official coding guidelines, and payer-specific requirements
- Assess clinical documentation for completeness and accurate CPT, ICD-10-CM, and HCPCS code assignment
- Analyze coding errors and trends, identify improvement opportunities, and give actionable feedback to coding teams
- Partner with coding managers and training teams on process improvement and coding education
- Maintain current knowledge of coding standards, payer regulations, and compliance requirements
- Guide and motivate team members while supporting production and quality objectives
- Manage inventory and planning activities
- Follow project protocols and operating instructions
- Resolve team questions and issues by researching grey areas and developing solutions
- Respond promptly to client emails and queries
- Escalate issues and identify emerging trends
- Maintain team compliance with HIPAA and OIG requirements
आवश्यकताएँ
- Bachelor’s degree in Science or Nursing
- At least one mandatory certification: CCS (Certified Coding Specialist), CIC (Certified Inpatient Coder), or CPC (Certified Professional Coder)
- At least 3 years of experience after certification
- Four to six years of coding experience, including quality work
- Mandatory IVR coding experience, including complex IVR coding, cardiovascular surgery, and general surgery
- At least one to two years of experience as a Quality Analyst or Quality Auditor
- CPMA certification is an advantage
- Based in Chennai
- Quality control experience
- Strong Microsoft Excel skills, including tracker management, analysis, and reporting
- Experience in SLA-driven, highly compliant healthcare environments
- Advanced knowledge of quality auditing and medical coding
- Ability to manage and support a team
- Strong analytical, problem-solving, research, and communication skills
- Ability to deliver team education and training
- Knowledge of HIPAA and OIG compliance
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