Medical coder

Cotiviti; Pune District; On-site; INR 500,000 - 800,000; Full time

Job summary

Cotiviti is seeking a Medical Coder to support client engagements by accurately assigning codes to medical procedures and diagnoses per policy requirements. You will analyze cases, ensure coding completeness, and support reimbursement processes.

The role requires strong knowledge of US healthcare coding, CMS/Medicaid regulations, and experience with ICD-9, CPT, and HCPCS, along with excellent communication skills and proficiency in MS Office.

Qualifications

• Experience in US Healthcare, medical coding, medical billing, RCM health plan operations strongly preferred.
• Knowledge of healthcare claims payment policy and processing CMS, Medicaid regulations, AAOS, ICD-9, CPT & HCPCS, etc.
• Practical clinical experience in hospital/office or nursing home preferred.
• General knowledge of medical procedures, conditions, illnesses and treatments.
• Excellent written and verbal communication skills with high attention to detail.
• Strong MS Office skills (Word, Excel, PowerPoint, Outlook).

Responsibilities

• Perform daily audits on client data for completeness and accuracy of coding to ensure reimbursement.
• Respond to provider appeals.
• Respond to client logics and record reviews.
• Monitor acceptance rates for assigned clients and help detect negative deviations.
• Provide feedback to Management/Development Teams to enhance editing and efficiency.
• Report work performance to team lead in a timely manner.
• Strive to meet and exceed productivity and quality benchmarks.
• Participate in relevant training and development activities.

Skills

US healthcare knowledge

Medical coding

Medical billing

RCM operations

Communication skills

MS Office (Word/Excel/PowerPoint/Outlo

CMS policies knowledge

ICD-9 CPT HCPCS knowledge

Education

Bachelor's degree (life sciences preferred)

Tools

CMS policies

Job description

POSITION DESCRIPTION

JOB TITLE: Medical Coder

General Summary

We are currently seeking Medical coder to support a growing client base while combining their clinical and/or coding expertise with payment accuracy. The Medical coder is responsible for analyzing and interpreting and assign the correct codes for the descriptions available on various medical procedures and diagnosis and other related medical coding as per the medical policy requirements.

Principal Duties / Responsibilities

• Perform daily audits on client data for completeness and accuracy of coding utilizing both coding and clinical background to ensure appropriateness for reimbursement
• Respond to provider appeals.
• Respond to client logics and record reviews
• Monitor acceptance rates for assigned clients and assist management in proactively detecting negative deviations.
• Contribute to PCI product by providing feedback to Management/Development Teams on changes to enhance editing and efficiency.
• Reports his/her work performance on a timely basis to the team lead
• Works diligently to meet and exceed productivity and quality benchmarks
• Takes charge of ongoing learning and development and participates in relevant training and development activities

Educational requirement

• Bachelors degree in any stream (preferably Life Science) with preferred CPC certification

Experience requirements

• Experience in US Healthcare, medical coding, medical billing, RCM health plan operations strongly preferred.
• Possesses knowledge of healthcare claims payment policy and processing specifically CMS, Medicaid regulations, AAOS, ICD-9, CPT & HCPCS, etc.
• Practical clinical experience working in a hospital/office or nursing home strongly preferred.
• Has general knowledge of medical procedures, conditions, illnesses and treatment practices
• Possesses excellent written and verbal communication skills. Ability to think logically and process sequentially with a high level of detailed accuracy and efficiency
• Has excellent personal computer skills in Microsoft Word, Excel, PowerPoint, Outlook, etc.