Job title: Senior Executive

Company: EXL Service

Job description: Job Description:

Overview:

SENIOR EXECUTIVE QUALITY AUDITOR is responsible performing quality reviews for coding auditors by analyzing codes documentation from medical records that determines payments. This position performs highly technical and specialized functions, and the primary function of this position is to perform a thorough review of patient encounters to assess for completeness and accuracy of provider documentation and CPT and HCPCS coding. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines.

Qualifications: * Life science Bachelor’s degree.

• Para – medical background (B.PT, Pharm, and B.SC. Nursing) graduation is an added advantage.

Experience * > 5 years of experience in coding Auditing, provider coding

• >2 years of experience in QA role.
• CPC/CCS/COC certification mandatory
• Excellent knowledge of multispecialty surgery coding including procedural coding, HCPCS coding
• Excellent verbal and written communication
• Experience in performing QA for 10-25 coders.
• Strong PC skills; Excel, Word, PowerPoint and internet based programs

Communication Skill:

Excellent verbal and written communication

Working Hours:

9 hours which includes 1-hour break

Telecommuter/Internet requirements, if applicable:

NA

Skills and abilities: * Reviewing medical documentation for appropriate ICD and CPT coding and documentation

• Providing feedback and education to coding auditors.
• Root cause analysis and action plan for critical errors.
• Planning and executing regular feedback and refresher sessions for team and individuals on need basis.
• Work towards meeting program quality SLA.
• Performing extensive research and analysis of appeal-data and processes to identify trends and emerging issues, and recommend best practices for maximum performance
• Following appropriate policies, procedures and guidelines ensuring compliance with state and federal laws, policies and regulations
• Providing recommendations to leadership to modify reference materials and processes that do not fully satisfy regulatory or legal compliance related to coding
• Initiating follow-up activities to reflect change for compliance
• Ability to apply critical thinking skills to coding policy interpretation and implementation
• Ability to work independently; well-organized and able to set priorities with minimal direction
• Ability to effectively communicate both verbally and in writing.

Expected salary:

Location: Chennai, Tamil Nadu

Job date: Sun, 10 Jul 2022 03:47:58 GMT

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