Lead quality audits of coded medical records (CPT, ICD-10-CM, HCPCS), identify coding errors and trends, provide feedback and training, manage and motivate a coding quality team, ensure HIPAA/OIG compliance, handle client queries, support process improvements, and stay current with coding standards and payer rules. Requires certification, nursing license, and specialist IVR coding experience.
- 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 -
- Active state nursing license mandatory
- 4 - 6 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.
About Us EXL (NASDAQ: EXLS) is a leading data analytics and digital operations and solutions company. We partner with clients using a data and AI-led approach to reinvent business models, drive better business outcomes and unlock growth with speed. EXL harnesses the power of data, analytics, AI, and deep industry knowledge to transform operations for the world’s leading corporations in industries including insurance, healthcare, banking and financial services, media and retail, among others. EXL was founded in 1999 with the core values of innovation, collaboration, excellence, integrity and respect. We are headquartered in New York and have more than 54,000 employees spanning six continents. For more information, visit www.exlservice.com.
EXL Chennai, Tamil Nadu, IND Office
Chennai, India
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