Senior Executive - Quality Auditor at Exl in Chennai, Tamil Nadu, IN

Experienced Quality Auditor – Medical Coding professional with CPC certification and a minimum of 4-7 years of post-certification coding experience. The ideal candidate must have strong expertise in IVR coding (complex cases), including cardiovascular and general surgery. Responsibilities include conducting coding quality audits, ensuring accuracy, and maintaining compliance with coding standards and guidelines. 3+years of experience after certification is must

• 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.

Responsibilities

• 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

Qualifications

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.