Clinical Data Analyst

1 week ago

Bengaluru, Karnataka, India beBeeCoding Full time ₹ 10,00,000 - ₹ 15,00,000
Medical Coding Specialist

Description:

The Medical Coding Specialist will review clinical documentation and assign appropriate diagnosis and procedure codes using ICD-10-CM, CPT, and HCPCS guidelines. The candidate must have strong knowledge of medical terminology, anatomy, and physiology. Proficiency with ICD-10-CM, CPT, HCPCS, and other coding systems is required.

Responsibilities:

  • Review clinical documentation and assign appropriate diagnosis and procedure codes
  • Conduct Risk Adjustment/HCC coding to identify and code chronic conditions accurately
  • Perform chart audits to evaluate documentation insufficiencies and ensure they support code assignments
  • Ensure coded data adhere to payer/regulatory guidelines and internal compliance standards
  • Resolve queries with providers or documentation authors when medical records are unclear or missing needed details
  • Maintain productivity and accuracy targets as set by the team/project
  • Stay updated with coding changes, industry regulations, payer policies, and coding certification requirements
  • Participate in ongoing training and process improvement initiatives
  • Assist in denial management, claims adjudication, revenue leakage identification, and support payment integrity (if applicable)
  • Maintain confidentiality and security of patient data (HIPAA/local laws)

Required Qualifications:

  • Certification: CPC (Certified Professional Coder) and/or CRC (Certified Risk Adjustment Coder)
  • Educational Qualification: Graduate degree in Life Sciences (e.g., B.Sc, B.Pharma, Biotechnology, Microbiology, Nursing)
  • Experience: 1-3 years coding experience in U.S. healthcare/risk adjustment/HCC/multispecialty coding
  • Strong knowledge of medical terminology, anatomy, and physiology
  • Proficiency with ICD-10-CM, CPT, HCPCS, and other coding systems
  • Good analytical skills, attention to detail, ability to work under deadlines
  • Communication skills: written and verbal
  • Computer skills: comfortable using EHR/EMR tools, basic MS Office (Excel, Word), coding/auditing software
  • Experience with payer policies, Medicare Advantage, Medicaid, RADV audits
  • Prior experience in facility setting (inpatient/outpatient) coding, or surgery/pathology specialties
  • Ability to mentor/train junior coders
  • Familiarity with coding compliance, appeals/denials handling

Benefits:

This role offers opportunities for professional growth and development in a dynamic and challenging environment.

About Us:

We are dedicated to providing high-quality healthcare services to our patients.

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