Medical Coding Specialist

4 days ago


Hyderabad, Telangana, India ModMed Full time
Job Title: Medical Coding Specialist - Quality Assurance Expert

About ModMed:
ModMed is a leading healthcare technology company dedicated to empowering doctors and patients through its intelligent, specialty-specific cloud platform. With a mission to modernize medicine, the company has grown to serve eleven specialties and has a global presence with offices in the US, Chile, Germany, and India.

Role Overview:
The Medical Coding Specialist - Quality Assurance Expert plays a critical role in ensuring the accuracy and quality of medical coding across various specialties. This position requires strong expertise in medical coding principles, regulatory guidelines, and analytical skills to identify areas for improvement and implement process enhancements.

Key Responsibilities:
  • Audit coding work performed by Global Partners and provide timely feedback to teams to resolve denied claims efficiently.
  • Review and analyze coding denials from payers to determine trends and implement preventive measures.
  • Serve as a point of contact for coding questions and clarifications for the MMI team.
  • Participate in coding educational opportunities to stay updated on payer guidelines and industry developments.
  • Assist in production coding for clients across various specialties and scopes.

Requirements:
  • 5+ years of experience in medical coding with a minimum of 2 years as an SME/Quality expert in multi-specialty settings.
  • Certification in CPC or CCS is mandatory.
  • Strong knowledge of Gastro, Orthopaedics, Ophthalmology, Dermatology, and Podiatry is preferred.
  • Hands-on experience in analyzing coding denials and resolving them effectively.
  • Good writing and verbal communication skills in English.
  • Ability to work independently during the India night shift.
  • Proficiency in MS Excel for data analysis and trend identification.
  • Expertise in supplying, auditing, and analyzing CPT, ICD codes, and modifiers.
  • Bachelor's or Master's degree in Science with a background in Anatomy.

Estimated Salary: $80,000 - $110,000 per annum (dependent on location and experience)

Benefits:
ModMed offers a comprehensive benefits package, including medical, dental, and vision coverage, 401(k) plan, paid time off, and professional development opportunities. Additionally, employees can participate in business resource groups, tuition reimbursement programs, and unlimited access to LinkedIn Learning.

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