Medical Coder Quality Assurance Analyst
5 days ago
- Conduct internal audits to ensure accuracy, consistency, and compliance with coding standards (ICD-10, CPT, HCPCS).
- Review denied or rejected claims for issues related to coding, documentation, and clinical validation.
- Identify and correct coding errors and discrepancies.
- Provide feedback and education to coders and healthcare providers to improve coding quality.
- Collaborate with billing and operations teams to resolve coding-related issues and improve revenue cycle performance.
- Maintain up-to-date knowledge of coding guidelines, regulatory changes, and payer requirements.
- Prepare detailed audit reports and recommend process improvements.
- Use coding software and EHR systems to support coding accuracy and documentation.
- Education: Graduate of a Medical Allied course (e.g., Nursing, Medical Technology, Physical Therapy).
Certification: Must hold an active coding certification such as:
CPC (Certified Professional Coder)
- CCS (Certified Coding Specialist)
- CIC, CRC, BCHH-C (depending on specialization)
Experience:
Minimum 6 months of Inpatient (IP) Coding experience.
- Preferably with prior experience in Quality Assurance related to medical coding.
Skills:
Strong attention to detail and analytical skills.
- Excellent communication and interpersonal abilities.
- Proficiency in MS Office (Word, Excel, PowerPoint).
- Familiarity with quality monitoring tools and documentation systems.
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