Hiring Ancillary Coders/QA

Job Description: Ancillary Coder/QA

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.
• Min 1 year of experience in 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.

Contact HR: Vedha Mithra 9010608096