Ikya Global
Key Responsibilities
E&M Coding & Documentation Review
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Review outpatient and inpatient E&M documentation, including office visits, hospital visits, consultations, emergency department notes, and progress notes.
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Assign accurate E&M CPT codes based on documented services and/or time, in compliance with U.S. E&M guidelines.
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Apply appropriate E&M modifiers (e.g., -25, -57, -24) to ensure correct billing and compliance.
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Ensure documentation supports the level of service selected and meets payer requirements.
Quality & Accuracy
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Maintain productivity and quality benchmarks (target accuracy ≥ 95%).
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Participate in internal audits and quality reviews.
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Identify and correct E&M coding discrepancies to reduce denials and downcoding.
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Implement audit feedback to improve coding quality.
Compliance & Regulatory Standards
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Ensure compliance with CMS, Medicare, and payer-specific E&M policies.
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Maintain strict HIPAA compliance and protect PHI.
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Follow internal SOPs, coding standards, and compliance policies.
Collaboration & Communication
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Work closely with QA teams, auditors, team leads, and operations managers to resolve E&M coding issues.
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Communicate with clinical teams to clarify documentation impacting time-based or service-based coding.
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Participate in training sessions, audits, and continuous improvement initiatives.
Continuous Learning
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Stay current with CPT E&M updates, CMS guideline changes, and payer policies.
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Participate in ongoing education and professional development programs.
Qualifications & Skills
Education
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Bachelor’s degree in Life Sciences, Nursing, Pharmacy, or a related field (preferred).
Experience
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Minimum 1 year of hands-on experience in E&M Medical Coding.
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Proven experience coding outpatient and/or inpatient E&M services.
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Strong exposure to U.S. healthcare reimbursement processes.
Certifications (Mandatory)
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Active coding certification is required.
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Accepted certifications include:
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CPC
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COC
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CCS
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Candidates without certification are not eligible.
Skills
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Strong knowledge of E&M CPT guidelines and documentation requirements.
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Excellent attention to detail and accuracy.
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Ability to meet productivity and quality benchmarks.
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Clear written and verbal communication skills.
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Strict adherence to SOPs and compliance standards.
