Clinical Coding Specialist

20 hours ago

Hyderabad, Telangana, India beBeeMedicalCoding Full time ₹ 18,00,000 - ₹ 24,00,000
Job Overview

A Medical Coder/Reviewer is responsible for reviewing patient medical records to ensure accurate coding and compliance with clinical guidelines.

Key Responsibilities:
  • Conduct thorough reviews of medical records to identify incorrectly coded services, diagnoses, modifiers, DRGs, APCs, and other coding irregularities.
  • Perform regular coding audits to detect and prevent alleged fraud, waste, and abuse perpetrated by healthcare providers and organizations.
  • Collaborate with law enforcement agencies to investigate and close cases involving coding irregularities.
  • Prepare comprehensive case files for referral to federal, state, and local law enforcement entities.
Requirements:
  • Minimum 7-9 years of relevant work experience in clinical coding or a related field.
  • Medical degree from a reputable university with clinical exposure.
  • Valid certification from a recognized professional organization (e.g. AAPC, AHIMA).
  • Strong knowledge of Anatomy, Physiology, and disease processes.

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