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 hidden_mobile .