ED Profee Coders/QA

Greetings from Eclat Health Solutions:

Job Summary

The ED Profee Medical Coder is responsible for reviewing, analyzing, and assigning accurate CPT, ICD-10-CM, HCPCS, and E&M codes for Emergency Department professional fee encounters. The coder ensures compliance with client requirements, payer regulations, CMS guidelines, and coding standards while maintaining productivity and quality targets.

Key Responsibilities

• Review Emergency Department physician documentation and assign appropriate:
  • CPT codes
  • ICD-10-CM diagnosis codes
  • HCPCS codes
  • E&M levels based on documentation
• Ensure coding accuracy and compliance with CMS, AMA, CPT, and coding guidelines.
• Abstract clinical information from medical records and apply correct coding principles.
• Query providers when documentation is incomplete or unclear.
• Identify coding opportunities and documentation improvement areas.
• Meet established productivity and quality benchmarks.
• Participate in internal and external coding audits.
• Stay updated with coding changes, payer regulations, and industry best practices.
• Maintain confidentiality and HIPAA compliance.

Required Qualifications

• Certified Professional Coder (CPC) from AAPC or Certified Coding Specialist (CCS) from AHIMA.
• Minimum 1+ years of ED Profee coding experience.
• Strong knowledge of:
  • Emergency Medicine coding
  • E&M guidelines
  • CPT, ICD-10-CM, and HCPCS coding systems
  • Medical terminology, anatomy, and physiology
• Experience working with EMR/EHR systems and encoder tools.
• Strong analytical and communication skills.

Preferred Qualifications

• Experience with Leveling Guidelines for Emergency Department encounters.
• Familiarity with US healthcare payer regulations and reimbursement methodologies.
• Experience in coding audits and quality assurance processes.

Work Location: Navi Mumbai

Interested Candidates can Reach out to HR Vedha Mithra 9010608096