Medical Data Analyst

2 hours ago

Mangalore, Karnataka, India beBeeCoding Full time ₹ 60,00,000 - ₹ 1,20,00,000
Medical Coding Specialist

Key Responsibilities:

  • Coding and Analysis: Conduct thorough analysis of clinical documentation to assign accurate diagnosis and procedure codes based on ICD-10-CM, CPT, and HCPCS guidelines.
  • Risk Adjustment/HCC Coding: Identify and code chronic conditions accurately to ensure compliance with payer and regulatory requirements.
  • Chart Audits: Perform regular chart audits to evaluate documentation insufficiencies and ensure they support code assignments.
  • Compliance: Ensure coded data adhere to internal compliance standards and regulatory guidelines.
  • Query Resolution: Resolve queries with providers or documentation authors when medical records are unclear or missing needed details.
  • Productivity and Accuracy: Maintain productivity and accuracy targets as set by the team/project.
  • Staying Current: Stay updated with coding changes, industry regulations, payer policies, and coding certification requirements.
  • Ongoing Training: Participate in ongoing training and process improvement initiatives.
  • Denial Management: Assist in denial management, claims adjudication, revenue leakage identification, and support payment integrity.
  • Confidentiality: Maintain confidentiality and security of patient data.

Required Qualifications and Skills:

  • Certification: CPC/CRC from recognized bodies.
  • Educational Background: Graduate degree preferably in Life Sciences.
  • Experience: Typically 1-3 years coding experience in U.S. healthcare/risk adjustment/multispecialty coding.
  • Medical Terminology: Strong knowledge of medical terminology, anatomy & physiology.
  • Coding Systems: Proficiency with ICD-10-CM, CPT, HCPCS, and other coding systems.
  • Analytical Skills: Good analytical skills, attention to detail, ability to work under deadlines.
  • Communication: Communication skills: both written and verbal.
  • Computer Skills: Computer skills: comfortable using EHR/EMR tools, basic MS Office.
  • Payer Policies: Experience with payer policies, Medicare Advantage, Medicaid, RADV audits.
  • Mentorship: Ability to mentor/train junior coders.

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