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Senior Medical Coding Expert

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Senior Medical Coding Expert

We are seeking a highly skilled Senior Medical Coding Expert to join our team.

Job Description:

  • Certifications:
    1. CPC - Certified Professional
    2. CCS - Certified Coding Specialist
    3. CIC - Certified Inpatient Coder
  • Experience: 9 to 12 years of experience in medical coding, auditing, and automation.

Required Skills and Qualifications:

  • Advanced knowledge of medical coding software platforms (e.g., 3M Code Finder, Optum360, True Code, Epic, Cerner, etc.).
  • Minimum 5 years of experience in Inpatient DRG coding.
  • Outpatient medical coding experience is an added advantage.
  • Mandatory working experience on US healthcare automation projects.
  • Knowledge on automation tools.
  • Programming language expertise (Python, SQL, R, etc.) is an added advantage.
  • Payer experience is an added advantage.
  • Expertise in Microsoft Outlook/Excel/Word/Power BI.

Benefits:

  • Automation of DRG Coding to streamline repetitive coding tasks.
  • Bringing AI-based solutions for DRG claims validations.
  • Improve compliance through predictive analytics.
  • AI-Assisted decision-making automations for diagnosis and procedure codes.
  • Ability to work with physicians, IT professionals, SMEs, and medical coders.
  • Solutions to automatically recognize and extract data from medical records to facilitate auditing.
  • Workflows Optimization.
  • Conducting UAT and providing feedback to the respective teams.
  • Retraining and evaluating the performance of the automated model.
  • Estimating or projecting the return on investment (ROI).
  • Perform analysis of benchmarking.

Others:

  • Oversee operations of healthcare facilities.
  • Manage staffing, scheduling, and resource allocation.
  • Stay updated on changes in healthcare.
  • Develop and implement quality improvement initiatives.
  • Strategic planning process to align organizational goals.
  • Engage in market analysis to understand the competitive landscape.
  • Maintain SOP and Audit manual.
  • Track key performance indicators (KPIs).