Medical Coding Specialist

2 weeks ago

Pune, Maharashtra, India beBeeCoder Full time US$ 50,000 - US$ 80,000
Medical Coding Specialist Job

  • Key Responsibilities:
  • Review clinical documentation to assign diagnosis and procedure codes using ICD-10-CM, CPT (and HCPCS if applicable) guidelines.
  • Conduct Risk Adjustment/HCC coding by identifying and accurately coding chronic conditions.
  • Perform chart audits to evaluate documentation insufficiencies and ensure they support code assignments.
  • Ensure coded data adhere to payer/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/project.
  • Stay updated with coding changes, industry regulations, payer policies, and coding certification requirements.
  • Participate in ongoing training and process improvement initiatives.
  • Assist in denial management, claims adjudication, revenue leakage identification, and support payment integrity (if applicable).
  • Ensure confidentiality and security of patient data (HIPAA/local laws).

Required Skills and Qualifications

  • Certification: CPC (Certified Professional Coder) and/or CRC (Certified Risk Adjustment Coder) from recognized bodies.
  • Educational Background: Bachelor's degree in Life Sciences (preferably).
  • Experience: Typically 1-3 years in U.S. healthcare/risk adjustment/HCC/multispecialty coding.
  • Strong knowledge of medical terminology, anatomy & physiology.
  • Proficiency with ICD-10-CM, CPT, HCPCS (if needed), and other coding systems.
  • Excellent 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 (Excel, Word), 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.

Professional Development Opportunities

The position offers opportunities for professional growth, including participation in ongoing training and process improvement initiatives, and staying updated with coding changes, industry regulations, and coding certification requirements.

Job Type

Full-time.

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