Senior Executive - Quality Auditor

• 3+years of experience after certification is must
• 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.
• 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

Education - Bachelor’s Degree in Science or Nursing.

Certifications

One or more of the following mandatory certifications

• 3+years of experience after certification is must
• CCS – Certified Coding Specialist
• CIC – Certified Inpatient Coder
• CPC – Certified Professional Coder
• Experience -

• 5 - 7 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 experience after certification is must
• 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.