Healthcare Coding Professional

17 hours ago

Jaipur, Rajasthan, India beBeeCoding Full time ₹ 98,11,900 - ₹ 1,24,97,700
Coding Specialist

Job Summary:

  • We are seeking a skilled and experienced Coding Specialist to join our team. As a key member of our coding department, you will be responsible for reviewing clinical documentation, assigning diagnosis and procedure codes using ICD-10-CM, CPT, and HCPCS guidelines.
  • In this role, you will also conduct risk adjustment/HCC coding to identify and accurately code chronic conditions, ensuring that coded data adhere to payer/regulatory guidelines and internal compliance standards.
  • Furthermore, you will perform chart audits to evaluate documentation insufficiencies and resolve queries with providers or documentation authors when medical records are unclear or missing needed details.
  • You will maintain productivity and accuracy targets as set by the team/project while staying updated with coding changes, industry regulations, payer policies, and coding certification requirements.

Required Qualifications:

  • Certification: Hold a recognized certification such as CPC (Certified Professional Coder) and/or CRC (Certified Risk Adjustment Coder).
  • Educational Qualification: Have a Bachelor's degree in Life Sciences or a related field.
  • Experience: Typically 1-3 years of coding experience in U.S. healthcare/risk adjustment/HCC/multispecialty coding.
  • Skills: Strong knowledge of medical terminology, anatomy & physiology. Proficiency in ICD-10-CM, CPT, HCPCS, and other coding systems. Good analytical skills, attention to detail, and ability to work under deadlines.
  • Communication and Computer Skills: Excellent communication skills (written and verbal) for interacting with providers, auditors, etc. Comfortable using EHR/EMR tools and basic MS Office applications.

Key Responsibilities:

  • Coding and Risk Adjustment: Review clinical documentation, assign diagnosis and procedure codes using ICD-10-CM, CPT, and HCPCS guidelines.
  • Chart Audits and Compliance: Perform chart audits to evaluate documentation insufficiencies and ensure they support code assignments.
  • Query Resolution and Productivity: Resolve queries with providers or documentation authors when medical records are unclear or missing needed details. Maintain productivity and accuracy targets as set by the team/project.
  • Staying Updated and Training: Stay updated with coding changes, industry regulations, payer policies (e.g., CMS, Medicare Advantage), and coding certification requirements. Participate in ongoing training and process improvement initiatives.

Benefits:

  • Certification: Opportunities for professional growth and development through ongoing training and certification programs.
  • Education: Collaborative environment that supports continuous learning and skill-building opportunities.

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