Medical Coder

2 days ago


Mohali Punjab, India SGH Management Indi Pvt. Ltd. Full time

Job Title: Medical Coder - Denials Management

Qualifications:

- **Education**: High school diploma or equivalent; an associate degree or higher in health information management or a related field is preferred.
- **Certification**: CPC, CCS, or other relevant coding certification is highly desirable

The Medical Coder in Denials Management is responsible for reviewing denied insurance claims, identifying reasons for denials, and ensuring accurate coding to facilitate proper reimbursement. This role involves collaboration with healthcare providers, billing departments, and insurance companies to resolve coding discrepancies and improve overall claim success rates.

Key Responsibilities:

- **Review Denied Claims**: Analyze denied claims to understand the reasons for denial and identify patterns.
- **Code Medical Procedures**: Accurately code diagnoses, procedures, and services according to relevant coding guidelines (ICD-10, CPT, HCPCS).
- **Re-Evaluate Claims**: Prepare and submit appeals for denied claims, ensuring all necessary documentation is included.
- **Collaboration**: Work closely with healthcare providers and billing teams to gather necessary information for claims resolution.
- **Documentation**: Maintain detailed records of denials and appeals to track trends and identify areas for improvement.
- **Compliance**: Ensure compliance with healthcare regulations and coding standards.
- **Training**: Provide training and support to staff on coding practices and denial prevention strategies.
- **Reporting**: Generate reports on denial rates and reasons to inform management and improve processes.

**Job Types**: Full-time, Permanent

Pay: ₹360,000.00 - ₹800,000.00 per year

**Benefits**:

- Food provided
- Paid sick time
- Provident Fund

Schedule:

- Evening shift
- Monday to Friday
- Night shift
- US shift

**Experience**:

- total work: 1 year (preferred)
- Medical Coding: 1 year (preferred)

License/Certification:

- CPC, CIC, COC (preferred)

Work Location: In person


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