We are seeking a detail-oriented and experienced Medical Coder to join our esteemed healthcare organization in Coimbatore, Tamil Nadu. This full-time position offers a fantastic opportunity for professionals with 2 to 8 years of experience in medical coding and a strong understanding of healthcare processes.
Responsibilities:
Assign appropriate medical codes (ICD-10, CPT, HCPCS) to diagnoses and procedures based on clinical documentation.
Review patient medical records to ensure accuracy and completeness of coding.
Perform claim adjudication and verification processes.
Ensure compliance with UAE healthcare regulations and coding guidelines.
Identify and resolve coding discrepancies and denials.
Collaborate with physicians and other healthcare professionals to clarify documentation.
Stay updated with the latest changes in medical coding practices and regulations.
Maintain confidentiality of patient information.
Qualifications:
Bachelor of Science (B.Sc.) degree in a relevant field.
Minimum of 2 years and a maximum of 8 years of experience in medical coding.
Proficiency in Claim Adjudication and understanding of the UAE healthcare process.
Knowledge of ICD-10, CPT, and HCPCS coding systems.
Strong analytical and problem-solving skills.
Excellent attention to detail and accuracy.
Good communication and interpersonal skills.
Relevant medical coding certification (e.g., CPC, CCS) is a plus.
Location:
Coimbatore, TN, 641018, India
To Apply:
Interested candidates are encouraged to submit their resume and cover letter for consideration. {{}}
experience
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Medical CoderJob Offer
We are seeking a detail-oriented and experienced Medical Coder to join our esteemed healthcare organization in Coimbatore, Tamil Nadu. This full-time position offers a fantastic opportunity for professionals with 2 to 8 years of experience in medical coding and a strong understanding of healthcare processes.
Responsibilities:
Assign appropriate medical codes (ICD-10, CPT, HCPCS) to diagnoses and procedures based on clinical documentation.
Review patient medical records to ensure accuracy and completeness of coding.
Perform claim adjudication and verification processes.
Ensure compliance with UAE healthcare regulations and coding guidelines.
Identify and resolve coding discrepancies and denials.
Collaborate with physicians and other healthcare professionals to clarify documentation.
Stay updated with the latest changes in medical coding practices and regulations.
Maintain confidentiality of patient information.
Qualifications:
Bachelor of Science (B.Sc.) degree in a relevant field.
Minimum of 2 years and a maximum of 8 years of experience in medical coding.
Proficiency in Claim Adjudication and understanding of the UAE healthcare process.
Knowledge of ICD-10, CPT, and HCPCS coding systems.
Strong analytical and problem-solving skills.
Excellent attention to detail and accuracy.
Good communication and interpersonal skills.
Relevant medical coding certification (e.g., CPC, CCS) is a plus.
Location:
Coimbatore, TN, 641018, India
To Apply:
Interested candidates are encouraged to submit their resume and cover letter for consideration. {{}}
<p>Position Overview: We are looking for a US Healthcare Data Integration SME to support our Payment Integrity client onboarding and operations in the US Healthcare domain. The role involves comprehensive understanding of EDI, Healthcare Claim Form (Professional - 1500), (Facility - 1450), EDI maps for ANSI X12 transaction sets to claims model, Client claims data mapping, Data specs management, Data transformation, Data integration support, Data integrity validating, Data classification and Managing healthcare data from multiple sources to ensure accurate claims analysis, audit processes, and payment accuracy and support client onboarding.</p><p> </p><p>Specialty Expertise:</p><p>Candidates must have proficiency in the following areas:</p><ul><li>Understanding of Revenue Cycle Management (RCM), US healthcare Claims & coding and billing.</li><li>Healthcare Claim Form (Professional - 1500), (Facility - 1450) and EDI maps for ANSI X12 transaction sets.</li><li>Medical Codes: CPT/HCPCS, ICD, DRG, Modifiers etc.</li><li>Provider Data: NPI, Taxonomy Codes across all providers.</li><li>Value sets: Standard value set in US healthcare.</li><li>Data Integrity Validation.</li><li>Data classification Metholodologies.</li><li>Preferable, Clinical Data Exchange – Understanding expertise in healthcare data exchange standards (HL7, FHIR,) and clinical terminologies (SNOMED, LOINC).</li></ul><p> </p><p>Key Responsibilities:</p><ul><li>EDI and Interoperability Leadership: Serve as the Subject Matter Expert (SME) for Electronic Data Interchange (EDI) and healthcare interoperability. Lead the full Software Development/Implementation/Onboarding Lifecycle (SDLC) for cross-functional projects, including requirements gathering, design, testing, implementation, and post-production support.</li><li>HIPAA X12 Specialization: Specialize in HIPAA-compliant X12 transactions, with a strong focus on the 837 (Healthcare Claim File), to support payment integrity operations, data workflows, and payer-provider or payer-payer data mapping and integration.</li><li>Data Specification Management: Design, develop, and maintain robust data claims model/Data Specification for healthcare claims and payment integrity systems for proof of concepts and Go-live.</li><li>Data Sourcing and Transformation: Integrate data from multiple sources, including claims systems, payer platforms, and external healthcare datasets. Perform essential data mapping, transformation, and validation to ensure data accuracy and consistency.</li><li>Collaboration and Alignment: Partner closely with technical teams, business analysts, and client teams to ensure regulatory compliance, seamless system integration, and process automation. Work with Payment Integrity, Analytics, and Technology teams to support audit and automation initiatives.</li><li>Operational Excellence & Compliance: Monitor ETL processes and troubleshoot integration issues. Ensure strict compliance with HIPAA and data security standards when handling sensitive healthcare data. Act as the primary Data Integration liaison between Client and internal teams, driving timely resolution, system compliance, and stakeholder alignment.</li></ul><p> </p><p>Team Development & Mentorship:</p><ul><li>Trained and mentored junior analysts, supporting team professional development and enhancing performance.</li><li>Developed onboarding guides and mentoring programs to support team expansion and knowledge retention.</li><li>Co-develop automated tools with IT to correct transaction errors in real-time, eliminating multi-week delays.</li><li>Collaborated with developers and cross-functional teams to enhance workflow efficiency and optimize system integration.</li></ul><p> </p><p>Client Communication: Data Integration</p><ul><li>Communicate effectively with clients to address and resolve data-related queries independently.</li><li>Analyze and interpret client-reported data issues and provide appropriate solutions.</li><li>Assist clients in ensuring smooth and accurate data integration processes.</li><li>Proactively coordinate with clients to clarify requirements and maintain efficient data workflows.</li></ul><p> </p><p>Requirements:</p><ul><li>Strong understanding of US Healthcare data and claims processing workflows.</li><li>Experience working with healthcare claims datasets and payer systems.</li><li>ANSI X12 transaction sets.</li><li>Claims Model mapping (EDI to Claims Model).</li><li>Understanding of medical coding systems including CPT, HCPCS, ICD, and modifiers.</li><li>Familiarity with dataset policies and rules such as Medicare and Medicaid guidelines, preferable.</li><li>Familiarity of standard healthcare value set, schema etc.</li><li>Experience in data mapping, transformation logic, and integration documentation.</li><li>Ability to analyze data requirements and translate them into data or business rules.</li><li>Strong attention to data accuracy, consistency, and validation.</li><li>Ability to collaborate effectively with cross-functional teams in a fast-paced environment.</li><li>Strong analytical and problem-solving skills.</li></ul><p>Qualifications:</p><p>Education & Certification (one of the following required):</p><ul><li>Medical or Life Sciences background (MBBS, BDS, BPT, BAMS, Nursing, Pharmacy, Life Sciences)</li></ul><p>Certification Requirements:</p><ul><li>Preferable:<ul><li>FHIR/HL7, EDI Certification</li><li>Certified Health Data Analyst (CHDA)</li></ul></li></ul><p>Experience:</p><ul><li>Experience in US Healthcare Data Integration (SME), US Healthcare Data Analysis with deep understanding of Claims model, EDI 837, X12, US healthcare Codesets and datasets.</li></ul><p>Key Skills:.</p><ul><li>Healthcare Claims Data Analysis.</li><li>Payment Integrity and Claims Adjudication Domain Knowledge.</li><li>Knowledge of code sets: CPT, HCPCS, ICD, DRG, PCS, Modifiers.</li><li>Understanding of Healthcare Claim Form (Professional - 1500), (Facility - 1450) and EDI maps for ANSI X12 transaction sets.</li></ul><p> </p><p>Work Location: Jayanagar - Bangalore.</p><p>Work Mode: Work from Office.</p><h3>experience</h3>10
Job Summary:<ul><li>Reviews and evaluates hospital outpatient medical record documentation to assign, sequence, edit and/or validate the appropriate ICD-10-CM and HCPCS/CPT codes. Perform coding and/or code validation across multiple entities. Applies all appropriate coding guidelines and criteria for code selections.Adheres to Company and HSC Coding Compliance policies and procedures for the assignment of complete, accurate, timely, and consistent codes for diagnoses and procedure.</li><li>Supervisor: Coding Manager</li><li>Supervises: None</li></ul>Duties (included but are not limited to):<br />> Using ICD-10-CM and/or HCPCS/CPT, assigns, validates, and/or edits codes for the following patient types:> Emergency room (ED)> Recurring (RCR) excluding Wound Care and Cardiac Cath, and<br />> Clinical (CLI) records<br />> Provider Office Visit (POV)<br />> Assigns, validates, and/or edits the ED E/M levels, and enters and/or validates charges for ED,OB ED and/or observation (OBV) infusions and/or injections.<br />> Assigns, validates, and/or edits procedure categories and modifiers.<br />> Maintains or exceeds established productivity standards.<br />> Maintains or exceeds established accuracy standards.<br />> Reviews all official data quality standards, coding guidelines, Company policies and procedures, and clinical/medical resources to assure coding knowledge and skills remain current.> Meets all educational requirements as stated in current Company and HSC policies.<br />> Utilizes the complete medical record documentation in code assignment, validation, and/or editing of codes. 2 Job Description:<br />> Follows all applicable coding guidance in assigning, sequencing, validation, and/or editing of codes.<br />> Initiates, validates, and/or edits physician queries in compliance with Company and HSC policy when appropriate<br />> As needed, may periodically be asked to perform Coding Account Resolution Specialist I (CARSI) duties.<br />> Practices and adheres to the “Code of Conduct” philosophy and “Mission and Value Statement”.<br />> Other duties as assigned.<h3>experience</h3>10
