Medical Data Analyst

2 days ago

Vizag, Andhra Pradesh, India beBeeCoder Full time ₹ 30,00,000 - ₹ 50,00,000

Key Responsibilities

  • Clinical Documentation Review and Coding:
  • Review and analyze medical records to assign accurate diagnosis and procedure codes using ICD-10-CM, CPT, and HCPCS guidelines.
  • Risk Adjustment and HCC Coding: Identify and code chronic conditions accurately in accordance with industry standards.
  • Conduct chart audits to evaluate documentation insufficiencies and ensure they support code assignments.
  • Ensure that coded data adhere to payer and regulatory guidelines and internal compliance standards.
  • 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 or project.
  • Stay updated with coding changes, industry regulations, payer policies, and coding certification requirements.
  • Participate in ongoing training and process improvement initiatives.
  • (If applicable) Assist in denial management, claims adjudication, revenue leakage identification, and support payment integrity.
  • Maintain confidentiality and security of patient data in accordance with HIPAA and local laws.
Required Skills and Qualifications
  • Certification: CPC (Certified Professional Coder) and/or CRC (Certified Risk Adjustment Coder) from recognized bodies.
  • Educational Qualification: Graduate degree preferably in Life Sciences.
  • Experience: Typically 1-3 years coding experience in U.S. healthcare/risk adjustment/HCC/multispecialty coding.
  • Strong knowledge of medical terminology, anatomy, and physiology.
  • Proficiency with ICD-10-CM, CPT, HCPCS, and other coding systems.
  • Good analytical skills, attention to detail, ability to work under deadlines.
  • Effective communication skills: both written and verbal.
  • Computer skills: comfortable using EHR/EMR tools, basic MS Office, and coding/auditing software.
  • Experience with payer policies, Medicare Advantage, Medicaid, RADV audits.
  • Prior experience in facility setting (inpatient/outpatient) coding, or surgery/pathology specialties.
  • Ability to mentor/train junior coders.
  • Familiarity with coding compliance, appeals/denials handling.

This is a challenging role for individuals who enjoy working with medical data and have strong analytical skills. If you possess a graduate degree in a life science field and have experience in coding, this could be the perfect opportunity for you.

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