AX
Job Description
Key Responsibilities:
E&M OP Coder
- Review physician documentation and code outpatient visits (office, ER, urgent care, etc.).
- Assign accurate ICD-10-CM and CPT codes based on E&M guidelines.
- Apply appropriate modifiers, MDM levels, and time-based coding when applicable.
- Ensure compliance with CMS, AAPC, and payer-specific guidelines.
- Maintain productivity and coding accuracy as per SLA.
E&M QA (Quality Analyst)
- Audit coded charts across multiple outpatient specialties (Internal Med, Family Med, ED, etc.).
- Identify coding variances, MDM level errors, and documentation gaps.
- Provide structured feedback and coaching to coders for continuous improvement.
- Stay current with CMS E&M updates and help align team standards.
- Maintain quality reports and ensure coding standards compliance.
Qualifications:
- Education: Graduate in Life Sciences, Paramedical, or Healthcare-related fields
- Certification (Mandatory): CPC, COC, CCS-P (AAPC/AHIMA)
- Experience:
- Coders: 1–3 years in E&M or outpatient specialty coding
- QA: 3–5+ years in E&M coding + minimum 1–2 years of auditing experience
Skills Required:
- Strong knowledge of ICD-10-CM, CPT, E&M 2021 guidelines
- Excellent understanding of Medical Decision Making (MDM) and time-based coding
- Proficient with encoder tools (3M, Optum, etc.) and EMR systems (Epic, Athena, eClinicalWorks)
- Familiar with NCCI edits, documentation integrity, and payer rules
- Strong written communication and QA documentation/reporting skills (for QA role)