RCM Coding Specialist

5 days ago


Hyderabad, Telangana, India ModMed Full time
Medical Coding Auditor 3

We are seeking a highly skilled Medical Coding Auditor 3 to join our team at ModMed. As a key member of our India Operations, you will be responsible for auditing the work of Global Partners and providing timely feedback to teams to aid in the quick resolution of denied coding claims.

Your Role
  • Audit the work done by Global Partners and provide timely feedback to teams to aid in the quick resolution of denied coding claims.
  • Review & work on Coding denials from the Payers.
  • Serve as a point of contact as coding SME for coding questions and clarifications for the MMI team.
  • Review claims assigned to practices due to Coding issues in order to find out any trends and will work with CAs if practice education/ intervention is required.
  • Analyse coding denials to determine trends where preventive measures can be placed, such as scrub edits, provider training, action plans, coder training, etc.
  • Participates in coding educational opportunities (webinars, internal training, etc.). Will keep updated on the Payer Guidelines impacting on supplying the Codes.
  • If needed, may assist in the production coding of clients of various specialties and scopes of coding.
Skills & Requirements:
  • 5+ years of working experience in medical coding domain where minimum 2 years' experience as SME/Quality in coding with Multi speciality experience
  • Certification Mandatory - CPC
  • Having strong knowledge in Gastro, Orthopaedics, Ophthalmology, Dermatology and Podiatry is preferred.
  • Hands on knowledge of Coding Denials on providing the resolution.
  • Good knowledge of Payer Guidelines to resolve the Denials related to Coding.
  • Good writing and Verbal communication in English
  • Can work independently during the India Night Shift
  • Can run reports and analyze the trends and scenarios. A strong hand in MS Excel will be a plus
  • Expert in supplying/auditing/ analyzing the CPT, ICD Codes along with appropriate Modifiers
  • CPC from AAPC or CCS from AHIMA
  • Bachelors or Masters in Science with a background of Anatomy
ModMed Benefits Highlights
  • High growth, collaborative, transparent, fun, and award-winning culture
  • Comprehensive benefits package including medical for you, your family, and your dependent parents
  • The company supported community engagement opportunities along with a paid Voluntary Time Off day to use for volunteering in your community of interest
  • Global presence, and in-person collaboration opportunities; dog-friendly HQ (US), Hybrid office based roles and remote availability
  • Company-sponsored Employee Resource Groups that provide engaged and supportive communities within ModMed


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