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    Job · 15528615

    CHENNAI · FULLTIME

    Manager - Operation

    EXL Service logo

    EXL Service

    Chennai · onsite · Posted 48d ago

    Sourced fromNaukri
    Undisclosed12–16 yrsfulltimeChennai

    About a minute. You'll make an account on the way through.

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    • Found the form on Naukri · 11 questions to answer1.4s
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    Section · 01

    About this role

    • Strong expertise in multi-specialty surgical coding, auditing, and payment integrity processes. 
    • In-depth knowledge of ICD-10-CM, CPT, HCPCS, modifier usage, and payer-specific coding guidelines. 
    • Comprehensive understanding of CMS, Medicare, Medicaid, LCDs, NCDs, commercial payer policies, and reimbursement methodologies. 
    • Proficiency in coding software, auditing tools, and Electronic Health Record (EHR) systems. 
    • Strong analytical and problem-solving abilities with a focus on identifying coding discrepancies and implementing process improvements. 
    • Excellent leadership, coaching, and team management skills. 
    • Effective communication and stakeholder management skills with the ability to collaborate across departments. 
    • High attention to detail and commitment to coding accuracy, compliance, and quality standards. 
    • Ability to manage multiple priorities, work independently, and meet deadlines in a fast-paced environment. 
    • Sound knowledge of healthcare regulations, including HIPAA, HITECH, and industry compliance requirements. 
    • Lead and manage a team of medical coding specialists, ensuring accurate and timely auditing of multi-specialty surgical claims. 
    • Provide coaching, training, and mentorship to enhance team performance and foster a collaborative work environment. 
    • Oversee coding workflows, assign priorities, and ensure productivity, quality, and turnaround time targets are consistently achieved. 
    • Stay current with coding guideline updates, payer policies, regulatory changes, and industry best practices, and communicate relevant updates to the team. 
    • Conduct regular coding audits and quality reviews to ensure compliance with coding standards, documentation requirements, and organizational policies. 
    • Collaborate with cross-functional teams, including Analytics, Repricing, Quality, and Compliance, to optimize coding operations and resolve coding-related issues. 
    • Monitor and analyze key performance indicators (KPIs), identify performance gaps, and implement continuous improvement initiatives. 
    • Apply payment integrity principles to identify coding inaccuracies, documentation deficiencies, billing errors, and revenue optimization opportunities. 
      • Serve as the subject matter expert (SME) for multi-specialty surgical coding and payment integrity, providing guidance to internal stakeholders and supporting accurate documentation and coding practices. 
    • Ensure compliance with healthcare regulations, including HIPAA, HITECH, CMS, Medicare, and commercial payer requirements.

    Experience:

    • CPC+ 3 years' experience in multi-specialty surgery coding including IVR, General surgery, Infusion and Injection and Radiation oncology 

    • Auditing and denial management experience (Optional) 

    • Extensive experience in medical coding, with a focus on surgery coding and strong knowledge of CPT, ICD-10-CM, and HCPCS coding systems.

      Qualification:

    • Bachelor’s degree in clinical or healthcare information management or a related field. Relevant certifications (e.g. CCS, CPC, CPMA) are mandatory.

      Communication Skill: 

    • Strong written (documentation) and oral communication skills

      Working Hours:

    • 40 hours per week as Full-time employee

    • Shift time: 8:00 PM IST - 5:00 PM IST

    • Weekends Off

      Telecommuter/Internet requirements, if applicable:

    • High Speed internet connection at home, must be broadband

    • Must understand and adhere with telecommuter policy.

    Sourced from naukri

    Section · 02

    Skills

    WritingAuditingCMSoral communicationUsageSurgerysurgicalcpticdhcpcsmedical codingSystemCertifiedteam managementtoolsleadershipHealthProcesssoftware codingcodingHealthcarePaymentsCommunication SkillsStakeholder ManagementanalyticalregulationsCoaching

    Section · Company

    About EXL Service

    EXL Service logo

    EXL Service

    Analytics & KPO

    39.1k+

    employees

    1999

    27 years old

    New York City,New York

    US

    ₹11.1L PA avg

    Avg at EXL Service

    About

    We make sense of data and drive your business forward

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