Designation-Quality Control Analyst – Medical Coding
Role Type-Medical Coding Auditor cum SME
Specialties-General Surgery Coding (CPT 10000–69999 / 1-series to 6-series)
Reports To-Head of Coding Integrity & Quality
Experience5+ years hands-on general surgery coding & auditing across CPT 1-series to 6- series
Location-Bangalore (Bengaluru), Karnataka
Work Mode-Work From Office – mandatory
Shift-Mid shift – 12:00 PM to 9:00 PM IST
Employment:Full-time
We are seeking an experienced Medical Coding Auditor cum SME with strong general surgery coding expertise to ensure coding accuracy, compliance, and quality across AI-coded and human-coded surgical charts. The role combines hands-on chart auditing with subject-matter leadership — validating CPT, ICD-10-CM, HCPCS and modifier assignment, delivering structured feedback to coders, and partnering with SME and data science teams to drive continuous improvement of AI-assisted surgical coding. The ideal candidate has practical coding experience across the full general surgery CPT range (1-series through 6-series), a strong grasp of surgical guidelines (CMS / AMA / NCCI), and the ability to
translate coding expertise into actionable inputs for both operations and AI model development.
Key Responsibilities
Domain
Key Activities
Surgical Coding Audits
- Audit AI-coded and human-coded surgical charts across the general surgery CPT range
- Validate CPT, ICD-10-CM, HCPCS and modifier accuracy
- Verify operative-note support for code selection and units
Error Identification & Analysis
- Identify missed codes, incorrect coding and compliance risks
- Document errors with clear CPT / ICD-10 / modifier rationale and guideline references
- Flag recurring error patterns for team-level education
Compliance Monitoring
- Ensure adherence to CMS, AMA and AHA guidelines and client-specific SOPs
- Apply NCCI edits, global surgery rules and modifier logic correctly
- Apply updated guideline and coding changes to daily audit practice
Feedback & Education
- Deliver structured, case-level feedback to coders
- Conduct feedback discussions and support continuous learning Identify training needs and contribute to coder development
Required Qualifications & Skills
● Minimum 5+ years of hands-on general surgery coding and auditing experience across CPT 1- series to 6-series.
● Active coding certification – CPC, COC, CCS, CGSC or equivalent (AAPC / AHIMA).
● In-depth knowledge of CPT, ICD-10-CM, HCPCS, surgical modifiers and NCCI / global surgery rules.
● Sound understanding of CMS, AMA and AHA coding and compliance guidelines.
● Strong operative-note interpretation skills and ability to validate code selection against documentation.
● Prior auditing and/or SME experience with proven error-analysis and feedback skills.
● Strong analytical, documentation and communication abilities.
● Comfortable working with AI / technology-driven coding workflows and collaborating with data science teams
Experience auditing AI-generated or automated surgical coding outputs.
● Exposure to surgical sub-specialties (e.g., orthopedics, ENT, cardiothoracic, neurosurgery).
● Experience contributing to SOPs, quality frameworks or coder training programs. .
Benefits:
Work Location: In person
