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Lead Assistant Manager - Coding Auditor

exl Service.com (India) Private Limited
Chennai, IND
Full-time
Lead
Hybrid
Discovered 2 weeks ago
Communication

Full Job Posting

Qualifications

  • Bachelor’s degree in Clinical or Healthcare Information Management or a related field.
  • Relevant certifications (e.g. CPC,CIC,CCS for DRG) are mandatory.
  • Extensive experience in medical coding, with a focus on DRG coding and strong knowledge of CPT, ICD-10-CM, HCPCS coding systems.
  • Proficient in using coding software and electronic health record (EHR) systems.
  • Strong analytical and problem-solving skills, with the ability to identify coding-related issues, propose solutions, and implement process improvements.
  • Excellent interpersonal and communication skills, with the ability to collaborate effectively with diverse stakeholders and build positive relationships.
  • Detail-oriented with a commitment to accuracy and compliance with coding guidelines and regulations.
  • Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment.
  • Demonstrated knowledge of healthcare industry regulations such as HIPAA and HITECH, and specific knowledge of CMS, Medicare, LCDs, NCDs, Medical Policies, Commercial payer processes and requirements.

Responsibilities

  • Lead and manage a team of medical coding specialist ensuring accurate and timely auditing of procedures across various specialties in accordance with industry standards, guidelines and regulatory requirements.
  • Provide guidance, training, and mentorship to the coding team, fostering a collaborative and high-performing work environment.
  • Oversee the coding workflow, prioritize work assignments, and ensure productivity and quality targets are met or exceeded.
  • Stay updated with changes in coding guidelines, payer policies, and industry trends related to surgery coding and payment integrity process and effectively communicate these changes to the team.
  • Conduct regular audits and quality checks to ensure compliance with coding guidelines, accuracy of coded data, and adherence to documentation requirements.
  • Collaborate with other departments, such as analytics, repricing, quality, compliance to optimize coding processes and resolve coding-related issues.
  • Monitor key performance indicators (KPIs) and develop performance improvement initiatives to enhance auditing efficiency, accuracy, and productivity.
  • Apply payment integrity processes and knowledge to ensure proper coding and billing practices, identify claim and documentation errors and deficiencies, and maximize revenue capture.
  • Serve as a subject matter expert on multi-specialty surgery coding and payment integrity, providing guidance and support to physicians, clinical staff, and other stakeholders to ensure appropriate documentation, coding, and auditing practices

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