Position Summary
The Ancillary Lab Coder is responsible for accurately reviewing and assigning ICD-10-CM diagnosis codes and other required data elements to laboratory encounters based on physician documentation, payer guidelines, and client-specific requirements. The coder ensures coding accuracy, compliance with regulatory standards, and adherence to productivity and quality expectations.
Key Responsibilities
- Review laboratory requisitions, physician orders, pathology reports, and supporting clinical documentation.
- Assign accurate ICD-10-CM diagnosis codes to laboratory encounters.
- Validate medical necessity based on payer-specific Local Coverage Determinations (LCDs), National Coverage Determinations (NCDs), and client guidelines.
- Identify missing, invalid, or conflicting documentation and escalate according to established processes.
- Ensure coding complies with ICD-10-CM Official Guidelines, CMS regulations, and client-specific coding policies.
- Verify diagnosis sequencing and coding completeness.
- Maintain productivity, quality, and turnaround time (TAT) targets.
- Participate in client updates, education sessions, and process improvement initiatives.
- Maintain confidentiality and comply with HIPAA regulations.
- Document coding decisions and maintain audit trails where applicable.
- Communicate coding-related issues to Team Leads and Quality Analysts.
Required Qualifications
- Graduate in Life Sciences, Pharmacy, Nursing, or an equivalent healthcare-related field.
- Certification such as CPC, CCS, COC, CIC, or RHIT/RHIA preferred.
- 1–3 years of experience in laboratory or ancillary medical coding.
- Strong knowledge of ICD-10-CM coding guidelines.
- Familiarity with laboratory testing, pathology, molecular diagnostics, and medical necessity guidelines.
- Experience using coding encoders (3M, Optum, TruCode, etc.) and EHR systems.
- Good analytical and communication skills.
- Proficiency in Microsoft Excel and Microsoft Office applications.
Preferred Knowledge
- LCD/NCD policies.
- Medical necessity validation.
- Clinical laboratory workflow.
- Pathology and molecular laboratory coding concepts.
- HIPAA and compliance standards.
Key Performance Indicators (KPIs)
- Coding Accuracy: 95%
- Productivity: As per client requirement
- Turnaround Time (TAT): Meet contractual SLA
- Compliance Score: 100%
- Attendance and Adherence: As per organizational policy
Open Positions :Coders and QA
Eligibility for Coder -Min 1 year
Eligibility for Qa- Min 4 Years
Work Mode: Work from office Initial 6 Months
Work Location : Hyderabad
Interested Contact : 9063528419 Apoorva HR
Regards
Talent Acquisition Team
Eclat Health Solutions India Pvt Ltd.
