Medical Coding Expert

7 hours ago


Kolkata, West Bengal, India beBeeCoding Full time ₹ 8,00,000 - ₹ 12,00,000

Professional Summary:

  • We are seeking a highly skilled Medical Coder to join our team. The ideal candidate will have expertise in ICD-10-CM, CPT, and HCPCS coding systems and strong analytical skills.

Job Description:

Coding Specialist

About the Role:

The successful candidate will be responsible for reviewing clinical documentation, assigning appropriate diagnosis and procedure codes, and conducting risk adjustment/HCC coding. They will also perform chart audits to evaluate documentation insufficiencies and maintain coded data adherence to payer/regulatory guidelines and internal compliance standards.

Key Responsibilities:

  1. Code Assignment: Review clinical documentation and assign accurate diagnosis and procedure codes using ICD-10-CM, CPT, and HCPCS guidelines.
  2. Risk Adjustment/HCC Coding: Conduct risk adjustment/HCC coding to identify and code chronic conditions accurately.
  3. Chart Audits: Perform chart audits to evaluate documentation insufficiencies and ensure they support code assignments.
  4. Coded Data Maintenance: Maintain coded data adherence to payer/regulatory guidelines and internal compliance standards.
  5. Query Resolution: Resolve queries with providers or documentation authors when medical records are unclear or missing needed details.
  6. Productivity and Accuracy Targets: Maintain productivity and accuracy targets as set by the team/project.
  7. Industry Updates: Stay updated with coding changes, industry regulations, and coding certification requirements.
  8. Training and Development: Participate in ongoing training and process improvement initiatives.
  9. Denial Management: Assist in denial management, claims adjudication, revenue leakage identification, and support payment integrity.
  10. Data Confidentiality: Maintain confidentiality and security of patient data (HIPAA/local laws).

Required Skills and Qualifications:

Certification: CPC and/or CRC from recognized bodies.

Educational Qualification: Graduate preferably in Life Sciences.

Experience: Typically 1-3 years coding experience in U.S. healthcare/risk adjustment/HCC/multispecialty coding.

Skills: Strong knowledge of medical terminology, anatomy & physiology. Proficiency with ICD-10-CM, CPT, HCPCS, and other coding systems.

Personal Qualities: Good analytical skills, attention to detail, ability to work under deadlines. Communication skills: both written and verbal. Computer skills: comfortable using EHR/EMR tools, basic MS Office, coding/auditing software.

Benefits:

  • Prior experience in facility setting coding, or surgery/pathology specialties.
  • Ability to mentor/train junior coders.
  • Familiarity with coding compliance, appeals/denials handling.


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