Pharmacy Coder and Auditor

2 weeks ago

Remote, India OptiClaim Business Solutions Full time

**About Us**:
OptiClaim Business Solutions is a leading provider of healthcare reimbursement and medical coding services. We are committed to excellence in our field, ensuring accurate, efficient, and compliant billing practices. Join our dynamic team of professionals and contribute to our mission of delivering top-notch coding solutions to our clients.

**Position Overview**:
**Key Responsibilities**:

- **Assign Codes**: Utilize standardized coding systems such as ICD, CPT, and HCPCS to accurately assign codes to medications, medical procedures, and pharmacy services.
- **Insurance Claims**: Prepare and submit insurance claims for pharmacy services, ensuring codes accurately reflect the services provided for proper reimbursement.
- **Billing and Reimbursement**: Collaborate with the billing department to ensure all pharmacy services are billed correctly, adhering to payer requirements and regulations.
- **Data Management**: Maintain accurate and detailed records of all coded information, ensuring data is up-to-date and entered into electronic health records (EHR) systems.
- **Compliance**: Ensure all coding practices comply with federal regulations, including those set by CMS, as well as state laws and industry standards.
- **Auditing and Reviewing**: Conduct audits and reviews of coding and billing practices to identify and correct errors or discrepancies, preventing fraud and abuse.
- **Communication**: Work collaboratively with pharmacists, healthcare providers, insurance companies, and other stakeholders to resolve coding issues and clarify procedures.

**Qualifications**:

- Minimum of 5 years of experience as a pharmacy coder.
- Certified Pharmacy Technician (CPhT) preferred.
- Certified Coding Specialist (CCS), Certified Professional Coder (CPC), or equivalent certification highly desirable.
- Proficiency in ICD, CPT, and HCPCS coding systems.
- Strong understanding of payer requirements and healthcare regulations.
- Excellent attention to detail and organizational skills.
- Strong communication and collaboration abilities.

**Benefits**:

- Competitive salary and benefits package.
- Opportunities for professional growth and development.
- Supportive and collaborative work environment.
- Flexible working hours and potential for remote work.

**OptiClaim Business Solutions is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.**

**Job Types**: Full-time, Permanent

Pay: ₹30,000.00 - ₹80,000.00 per month

**Benefits**:

- Commuter assistance
- Provident Fund
- Work from home

Schedule:

- Monday to Friday
- Night shift
- US shift

Supplemental pay types:

- Performance bonus
- Shift allowance

**Experience**:

- Medical Coding: 6 years (preferred)
- Pharmacy Coding: 4 years (preferred)

License/Certification:

- CPhT, CCS, CPC; Proficient in ICD, CPT, HCPCS (preferred)

Work Location: Remote

Application Deadline: 24/05/2024

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