Quality Auditor, Medical Coding
Job Description
Key Skills
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Quality Auditor, Medical Coding
Job Responsibilities
Perform daily coding audits based on assigned audit sample coverage
Maintain at least 95% quality accuracy while collaborating effectively with team members and leaders
Ensure compliance with the company’s Coding Compliance Policy for both internal and external (client) audits
Identify coder performance gaps and recommend improvements to enhance overall coding quality
Utilize and demonstrate working knowledge of the EPIC system
Educational Requirements
Must hold certification from AHIMA or AAPC
Registered Nurse (RN) is preferred but not required
At minimum, candidates must be college graduates
Experience Requirements
At least 4 years of medical coding experience
Prior BPO experience in medical coding is required
Strong working knowledge of:
Emergency Department (ED) and Observation coding
General surgical and bedside procedures
Injection & Infusion (I&I) coding, including:
IV push
Chemotherapy
Non-chemotherapy infusion
Hydration
Proficiency in:
Use of modifiers
Surgical supply charges
Resolving NCCI edits
Experience validating Revenue Codes:
0760 – Treatment/Observation Room
0762 – Observation Room
0761 and 0769 – Specific treatment rooms (as applicable)
Familiarity with:
Carve-out procedure times
HCPCS codes (e.g., G0378, G0379)
Medical necessity requirements
Role
QA Analyst
Timings
Rotational Shifts (Permanent)
Industry
Medical / Healthcare / Hospital
Work Mode
Work from office
Functional Area
ITES / BPO / Customer Service
Note: Myglit doesn't charge any money from candidates. If you have been asked to pay money to get this job then report to us immediately at support@myglit.com.
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