Expert Medical Coding Professional

Job Description:

• We are seeking an experienced Healthcare Coding Specialist to join our team. As a key member of the organization, you will be responsible for generating and maintaining medical/pharmacy codes for use in defining conditions/events/treatments in studies using administrative healthcare data/electronic health record and insurance claims databases or other health records through critical review of published literature/keyword searches of coding dictionaries and/or coding software.
• The ideal candidate will have excellent communication skills, be able to work independently and as part of a team, and possess strong analytical and problem-solving skills.
• Key Responsibilities:
  • Accountable to understand scope of the request and generate/maintain medical/pharmacy codes (e.g., ICD-10-CM, HCPCS, CPT, NDC, SNOMED, LOINC, etc.)
  • Drive stakeholder engagement by identifying real-world coding needs for upcoming real-world database studies and provide expert consultation to partners on the appropriate selection of code sets based on the needs of a given study and real-world data set.
  • Maintain a coding library platform to house previously generated code sets.
  • Proactively identify ways to support the re-use of previously defined and standardized code sets for frequently used concepts by using coding library platform.
  • Identify the scope of automation in code list generation process and come up with a plan to collaborate with R&D tech and RWA on better ways to implement it.
  • Effective literature review to be able to create/review/update code list precisely.
  • Document/archive code lists when complete in the coding library platform/decommission code lists with relevant documentation when appropriate.
  • Lead the effort to update the Repository data internal platform (RDIP) dictionary with the latest ICD9 CM, ICD10 CM, LOINC, ICD9 UK, ICD10 UK, SNOMED, CPT, and HCPCS codes when external coding tools are unavailable.
  • Learn and deliver code lists of new coding systems used in new datasets/systems like Japanese datasets/SEER registry etc.
  • Preferable to have knowledge of MedDRA and WHODrug dictionaries.
  • Help/Advice drive with the leadership team to develop systems/tools on code list management internally and externally to ensure they are fit for purpose.
  • Able to trouble shoot coding related issues technical/process and know where to go to get support if required (e.g., IT support).
  • Able to use sophisticated technical tools (e.g., R programs) for code list creation.
  • Define/drive metrics and reports creation for Senior Management essential for seamless delivery and operations.
  • Acquires healthcare industry and system knowledge while working on code list requests.
  • Shares this knowledge with colleagues to make them aware of the code list generation process while also learning from their experiences in return.
  • Communicates effectively and precisely on regular code list updates flags risks proactively and negotiates on reasonable timelines.
  • Identify opportunities for process improvements and implement innovative solutions to enhance efficiency and quality of clinical code list generation process.
  • Provide expert guidance/support to project teams/vendors on Clinical coding process.
  • Maintain a first time right mindset to ensure high-quality deliverables.
  • Accountable for the accuracy/reliability of application of Clinical coding Standards.

Required Skills and Qualifications:

• Professional experience in healthcare coding field.
• Strong knowledge of medical/pharmacy codes (e.g., ICD-10-CM, HCPCS, CPT, NDC, SNOMED, LOINC, etc.).
• Ability to analyze and interpret complex data.
• Excellent communication and collaboration skills.
• Strong problem-solving and analytical skills.
• Proficiency in using sophisticated technical tools (e.g., R programs).
• Knowledge of MedDRA and WHODrug dictionaries is preferable.

Benefits:

• Opportunity to work in a dynamic and growing organization.
• Competitive salary and benefits package.
• Professional development opportunities.

Others:

• Must be willing to learn and adapt to changing environment.
• Ability to work independently and as part of a team.
• Strong organizational and time management skills.
• Good attention to detail and ability to meet deadlines.
• Compliance with all regulatory requirements.