Coding Services Quality Analyst

Job Description:

Position: Coding Services Quality Analyst

Shift Timings: 11 AM to 08 PM

Years of Experience: 5 Years

Job Mode: Work From Office

Job Location: Noida

JOB PURPOSE / ROLE

The Coding Services Quality Analyst ensures accuracy, compliance, and quality of medical coding and documentation within healthcare records. This role is essential in maintaining regulatory standards, supporting accurate coding processes, and minimizing compliance risks. The Quality Analyst collaborates with the Coding Services Manager and Director. The Quality Analyst will provide feedback and necessary training as needed.

This position may involve remote, hybrid, or in-office work depending on organizational needs. Regular access to secure systems for coding review is required.

JOB DUTIES AND RESPONSIBILITIES

Quality Assurance and Auditing

• Perform regular audits of coded medical records to ensure compliance with ICD-10-CM, CPT, HCPCS and Modifiers standards.
• Identify and correct coding errors to optimize coding accuracy and minimize denials.
• Evaluate documentation to confirm it supports the assigned codes.
• Specific specialties include (but not limited to):

E/M

ED (Emergency Department)

UC (Urgent Care)

All primary care

Behavioral Health

Minor Surgeries

Compliance Monitoring

• Monitor coding practices for adherence to federal and state regulations, including HIPAA, CMS guidelines, CPT Assistant, coding clinic and other applicable standards.
• Support the organization in maintaining compliance with internal policies and external audits.

Data Analysis and Reporting

• Compile audit results and prepare detailed reports to identify trends, gaps, and areas for improvement.
• Track quality metrics and provide recommendations for process enhancements.
• Identify under coding, over coding, or miscoding issues that could result in compliance risks.
• Track and report on key performance indicators (KPIs), such as coding accuracy rates and compliance adherence.

Education and Training

• Provide feedback and training to medical coders on identified errors and best practices.
• Assist in the development and delivery of educational materials on coding updates and guidelines.

Collaboration

• Work closely with Coding Services Manager and Coding Services Director

TECHNICAL COMPETENCIES (MINIMUM QUALIFICATIONS/EDUCATION/EXPERIENCE/ SKILL SET)

Minimum Qualifications and Education:

• Associate's or bachelors degree in health information management, or a related field (preferred).

No. of Years Work Experience

• Minimum 5 years of experience in medical coding.
• Minimum 2 years of experience auditing coded records, and mentoring staff.
• Familiarity with various EHR systems and coding software.

Skills Sets / Specialized knowledge

Key Skills Needed (Must Have)

• Strong understanding of medical terminology, anatomy, and coding guidelines (ICD-10, CPT, HCPCS).
• Attention to detail and analytical thinking.
• Proficiency in auditing and quality assurance practices.
• Strong communication and interpersonal skills to provide constructive feedback.
• Ability to manage time and prioritize tasks effectively.
• Proficiency in Windows, Excel, Word, PowerPoint
• Strong ability to troubleshoot
• Experience working with diverse teams and a global workforce.

Trainings / Certifications (specific to the Job)

Key Skills Needed (Must Have)

Certified Professional Coder (CPC) or Certified Coding Specialist (CCS), or equivalent certification required. Would consider Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA).